PHYSICAL ACTIVITY AND EXERCISE DURING PREGNANCY: KNOWLEDGE, PERCEPTION, AND EFFECT ON PREGNANCY OUTCOMES AMONG WOMEN IN AFRICA

1.1 Introduction

Exercise for pregnant women comprises the daily living activities, interests or hobbies and living demands they must fulfill each day (Taylor et al., 2008). World Health Organization (2017) recommends at least 150 min of moderate or 75 min of vigorous aerobic physical activity for individuals aged 65 years and above (or an equivalent combination). Few researches have targeted effects of exercise on old people. Daily movement or activities reduces with advance in age however this does not mean that it is not necessary for old people to do exercise. Pregnant Women care emphasizes the social and personal requirements of senior citizens who need some assistance with daily activities and health care, but who desire to age with dignity (Ayres, 2008).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.

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1.2 Background of Study

Historically, pregnancy was regarded as a state of confinement. More recently, however, research has demonstrated many potential health benefits of aerobic and strength-conditioning exercise in pregnancy and the postpartum period. It is now considered safe, and even advisable, for otherwise healthy pregnant women to initiate or continue an active lifestyle during pregnancy. Many anatomical and physiological changes take place during pregnancy and while there is no evidence to suggest that exercise in pregnancy is associated with any maternal of fetal adverse outcomes, it is prudent to adjust exercise regimes where necessary to avoid potential harm. Contact sports as well as sports associated with a risk of falling should be avoided. Brisk walking, stationery cycling, and swimming are examples of aerobics exercises that are recommended in pregnancy.

This high physical workload was believed to contribute to the high incidence of low birth weight (Rao et al., 2003). However, there are only a few published studies on physical activity among pregnant women in low-income countries, and most have based on questionnaires (Hjorth et al., 2012).

As it has been noted that the majority of the population is aging, there is a great need for health promotion of elderly in order to enable them to carry out day to day tasks independently. Exercise as the most common and effective way of boosting health has been advocated among elderly for years. However, elderly people who have multi-illnesses have restricted activities due to their general condition. By age 75, about one in three men and one in two women engaged in no physical activity (Harber 2007, 139).

According to the authors of this thesis, exercise has been underestimated or even ignored in real implementation which brings about patients' physical deterioration. The authors of this thesis have encountered various examples during previous practical experiences. In health care it has been assumed that health is basically maintained through nutrition and drugs. For example, sleeping problem is more common with the elderly and it surely affects individuals and their families. Often elderly patients use a lot of drugs for this problem including sleeping pill many of which have side effects. The results of Fa¡bio' s present study indicate that, elderly subjects submitted to chronic moderate training presenting improved sleep quality (Fábio et al., 2011, 113-118).

The purpose of this research is to explore ways in which exercise functions as a boost to elderly health promotion. The increasing number of people living longer has led to international interest in the enhancement of quality of life and health-related quality of life in older age (Bowling 2005, 1).

Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Knowledge, Perception, and Effect of Physical Activity and Exercise during Pregnancy on Pregnancy Outcomes among Women.

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1.3 Statement of Problems

Investigation revealed that physical exercise particularly before pregnancy and in the early stages of pregnancy has been shown to be beneficial in preventing and controlling gestational diabetes mellitus. It is therefore necessary to encourage early booking of pregnancy in order to realize more benefits from physical activity as pregnant women do get contact with health care professionals early that will give appropriate health education.

Measurement of physical activity in Africa has its own challenge. Most of the questionnaires that have been developed are appropriate for the developed world and might not apply in the resource limited setting in Africa (Wareham et al, 2000). Though the instruments used have high reliability, issues of validity remain a problem. This is because physical activity is multidimensional encom-passing such concepts as energy expenditure and aerobic fitness. Selection of a measurement method that can be used as the comparison or gold standard is very difficult.

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1.4 Aim and Objectives of Study

The aim of the study is to examine the Knowledge, Perception, and Effect of Physical Activity and Exercise during Pregnancy and its Outcomes among Women in Africa. In achieving this aim, the following specific objectives were laid out as follows:

1. To examine the factors influencing physical activity among pregnant women in the area under study;
2. To determine the level of physical activity among pregnant women in the study area;
3. To assess the attitude and knowledge of Physical Activity and Exercise during Pregnancy; and
4. To explore the status of physical activity and factors influencing physical activity in pregnant women in Africa.

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1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• Are there factors influencing physical activity among pregnant women in the area under study?
• What is the level of physical activity among pregnant women in the study area?
• What is the attitude and knowledge of Physical Activity and Exercise during Pregnancy?
• What is the status of physical activity and factors influencing physical activity in pregnant women in Africa?

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1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There are no significant factors influencing physical activity and exercise among pregnant women in the area under study
• H1: There are significant factors influencing physical activity and exercise among pregnant women in the area under study

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1.7 Significance of Study

The study will beneficial by providing information about lack of exercise during pregnancy which might result in loss of muscular and cardiovascular fitness, excessive maternal weight gain with a raised risk of GDM, varicose veins, dyspnea, lower back pain and poor psychological adjustment (Royal College of Obstetricians and gynecologists - RCOG, 2006).

An initial approach to becoming more physically active could be to encourage women to incorporate unstructured physical activity into daily living, both before and during pregnancy. Giving women an appropriate exercise prescription can encourage them to participate in physical activity (Colberg et al., 2013).

This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

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1.8 Scope of Study

The scope of the research is focused on the Knowledge, Perception, and Effect of Physical Activity and Exercise during Pregnancy and its Outcomes among Women in Africa. The study is limited to some Women in Nigeria.

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1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Establishment Policies: Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this project work. There were lots of information needed from the staffs of this establishment to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.
3. Research material: availability of research material is a major setback to the scope of the study.
4. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
5. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

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1.10 Definition of Terms

Perception: To notice something in a particular way or hold a view about something.