an examination of the role of antenatal care attendance in ...

Worldwide, the percentage of low birth weight infants in 2000 was 15.5 percent, 16.5 percent in
developing countries and only seven percent in developed countries. The Asian continent is estimated
to be having highest proportion of low birth weights, followed by the African continent. Within the
African region, Northern and Western Africa are estimated to have the highest proportion of low birth
weights (15.4 percent), followed by the Southern Africa region (14.6 percent), and Middle Africa (12.3
percent) (WHO 2004). A study conducted in Harare hospital, Zimbabwe, shows that the rate of low
birth weight was 199 per 1000 (Feresu et al. 2004).
In Zimbabwe, low birth weight was associated with older mothers aged 35+, rural residence and
multiple gestation (Feresu et al. 2004). However, according to WHO (2004), low birth weight is
associated with preterm births (before 37 weeks of gestation) or intra- uterine growth retardation. The
causes of prematurity is unknown in many cases, however, they may include high maternal blood
pressure, hard physical work, domestic abuse, acute infections, including TB and HIV/AIDS, stress and
other psychosocial factors (Bale, Stoll and Adekokuno 2003). On the other hand, intra-uterine growth
retardation is likely to be caused by unhealthy maternal lifestyle factors, such as consumption of
alcohol, cigarette smoking, substance abuse and poor nutrition.
It is generally recognized that being born with low birth weight is a disadvantage for the infant. Infants
born with low birth weight suffer from high rates of morbidity and mortality and often remain
underweight, stunted or wasted from the neonatal period through childhood (WHO 2004). In addition,
low birth weight may affect the person throughout life with poor growth in childhood, and a higher
incidence of adult diseases, such as Type II diabetes, hypertension and cardiovascular diseases, and if
they are females, may have higher risk of having low birth weight babies when they become mothers
(ibid).
2.1.3 Caesarean section
A caesarean section is a surgical process to deliver a baby, which is usually performed when a vaginal
delivery would put the baby or mother's life at risk, though in recent times it has been performed upon
request (Fenton et al. 2003). There has been considerable debate over the years as to what represent
reasonable rates of cesarean section. The World Health Organization (WHO) suggests that rates of
caesarean sections should be between 5-15% in the world (WHO 1994). Debate around these numbers
has centered on implications that rates under 5% suggest that perhaps the population does not have
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