Malaysian Journal of Public Health Medicine 2011, Vol. 11(2): 13-21 KNOWLEDGE, ATTITUDE AND PRACTICE ON ANTENATAL CARE AMONG ORANG ASLI WOMEN IN JEMPOL, NEGERI SEMBILAN Rosliza AM 1 , Muhamad HJ 1 1 Faculty of Medicine & Health Sciences, Universiti Putra Malaysia. ABSTRACT The maternal health status of Orang Asli women in Malaysia was noted to be lower as compared to other groups of population in the country. This study aimed to determine the level of knowledge, attitude and practice on antenatal care, which is a vital component of maternal health among the Orang Asli women in three Orang Asli villages in Jempol District, Negeri Sembilan. All women aged between 15 to 49 years old who had at least one antenatal experience were interviewed using a structured, pretested questionnaire. A total of 104 women were interviewed. Among them, 92.3% admitted attending antenatal clinic during their previous pregnancies while only 48.1% came early for their first check-up. About 70% of the women had history of home delivery and 44.2% had experienced at least one high risk pregnancy before. Study revealed that 44.2% (95% CI, 34.7 – 53.7%) of the women have good knowledge regarding antenatal care while 53.8% (95% CI, 44.3 – 63.1%) of them noted to have positive attitude regarding antenatal care. However, result showed that the level of knowledge regarding the importance of early antenatal care, screening test and complications of diabetes and hypertension in pregnancy were poor. In conclusion, the rate of home delivery and late antenatal booking was still high among the Orang Asli women and it is significantly associated with their attitude regarding antenatal care. These findings can be used to plan a customized health intervention program aiming to improve the maternal health practices and eventually improve the health status of the Orang Asli women. Key words: Antenatal care, knowledge, Malaysia, Orang Asli, practice. INTRODUCTION Appropriate antenatal care is one of the pillars of Safe Motherhood Initiatives, a worldwide effort launched by the World Health Organization (WHO) and other collaborating agencies in 1987 aimed to reduce the number of deaths associated with pregnancy and childbirth 1 . It highlights the care of antenatal mothers as an important element in maternal healthcare as appropriate care will lead to successful pregnancy outcome and healthy babies. All pregnant ladies are recommended to go for their first antenatal check-up in the first trimester to identify and manage any medical complication as well as to screen them for any risk factors that may affect the progress and outcome of their pregnancy. According to the Perinatal Care Manual recently edited by the Ministry of Health Malaysia, primigravida women are advised to go for a total of ten visits during their pregnancy and for multigravida women, the total recommended antenatal visit is seven sessions 2 . The Maternal Mortality Ratio (MMR) in Malaysia has been maintained to be below 40 per 100,000 livebirths since the 1990s 3 . However, there are still groups of marginalized women with poor maternal health status in Malaysia such as the Orang Asli women as demonstrated elsewhere in the world among other indigenous communities 4,5 . The Orang Asli, the indigenous minority community of Peninsular Malaysia, are considered one of the marginalized group due to their impoverished condition and lack of access to resources. There were 141,230 Orang Asli population in 2008 and 50% of them were categorized to be in hard-core poverty group. They are usually divided into three main groups: Senoi (54.1%), Proto-Malay (42.7%) and Negrito (3.2%) 6 . Midwives and traditional healers are important figures in the Orang Asli traditional health system. It was reported that the MMR among Orang Asli women in 2002 was 480 per 100,000 livebirths, which was more than ten times higher as compared to the national data of 30 such deaths per 100,000 livebirths in the same year 3,7 . Although the health status of Orang Asli women has improved over the years, it is still not at par with the national benchmark. Among the Orang Asli women in Negeri Sembilan in 2009, the MMR was reported to be 35.7 per 100,000 livebirths which was about 30% higher than the national rate 8 . The antenatal care ORIGINAL ARTICLE