title: Determinants of Antenatal Care Attendance among Pregnant Women Living in Endemic Malaria Settings: Experience from the Democratic Republic of Congo.
abstract: Background. Antenatal care (ANC) attendance helps pregnant women to benefit from preventive and curative services.Methods. Determinants for ANC attendance were identified through a cross-sectional survey in the Democratic Republic of Congo. Sociocultural bottlenecks were assessed via focus groups discussion of married men and women.Results. In this survey, 28 of the 500 interviewed pregnant women (5.6%) did not attend ANC services and 82.4% booked over the first trimester. The first visit is positively influenced by the reproductive age (OR: 0.52, 95% CI(0.28-0.95),p< 0.04), the educational level (OR: 0.41,95% CI(0.17-0.97),p< 0.04), the nearby health center (OR: 0.43, 95% CI(0.2-0.92),p< 0.03), and the presence of a male partner (OR: 10.48, 95% CI(2.1-52.23),p< 0.001). The barriers to early booking were (i) the cost of service; (ii) the appearance or individual income; (iii) the geographical inaccessibility or distance to health facilities; (iv) social and religious prohibitions; (v) the stigmatization from other women when conceiving in the late ages or young or while still lactating (parity); (vi) the time for waiting for services.Conclusion. The early ANC attendance is delayed among poor women with little education and living alone.
authors.affiliation: University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Célestin Ndosimao
authors.identifier: 0000-0001-7758-9464
authors.initials: CN
authors.lastname: Nsibu
authors.affiliation: Department of Anthropology, Faculty of Social, Administrative and Political Sciences, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Célestin
authors.initials: C
authors.lastname: Manianga
authors.affiliation: Department of Anthropology, Faculty of Social, Administrative and Political Sciences, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Serge
authors.initials: S
authors.lastname: Kapanga
authors.affiliation: Reproductive Health Program, Provincial Coordinator, Kananga, Western Kasai, Democratic Republic of the Congo.
authors.forename: Esther
authors.initials: E
authors.lastname: Mona
authors.affiliation: Health District Coordinator, Mbanza-Ngungu, Bas-Congo Province, Democratic Republic of the Congo.
authors.forename: Philippe
authors.initials: P
authors.lastname: Pululu
authors.affiliation: University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
authors.forename: Michel Ntetani
authors.identifier: 0000-0002-7479-1170
authors.initials: MN
authors.lastname: Aloni