Antenatal and Delivery Services in Kinshasa, Democratic Republic of Congo: Care-seeking and Experiences Reported by Women in a Household-based Survey
Identifieur interne : 001F13 ( Pmc/Curation ); précédent : 001F12; suivant : 001F14Antenatal and Delivery Services in Kinshasa, Democratic Republic of Congo: Care-seeking and Experiences Reported by Women in a Household-based Survey
Auteurs : Lydia Feinstein [États-Unis] ; Bavon Mupenda ; Sandra Duvall [États-Unis] ; Jean Lambert Chalachala ; Andrew Edmonds [États-Unis] ; Frieda Behets [États-Unis]Source :
- Tropical medicine & international health : TM & IH [ 1360-2276 ] ; 2013.
Abstract
Increasing coverage of quality reproductive health services, including prevention of mother-to-child transmission services, requires understanding where and how these services are provided. To inform scale-up, we conducted a population-based survey in Kinshasa, Democratic Republic of Congo.
Stratified two-stage cluster sampling was used to select women ≥18 years old who had been pregnant within the prior three years. Participants were interviewed about their reproductive healthcare utilization and impressions of services received.
We interviewed 1221 women, 98% of whom sought antenatal care (ANC). 78% of women began ANC after the first trimester and 22% reported <4 visits. Reasons for choosing an ANC facility included reputation (51%), friendly/accessible staff (39%), availability of comprehensive services (29%), medication access (26%), location (26%), and cost (21%). Most women reported satisfactory treatment by staff, but 47% reported that the ANC provider ignored their complaints, 23% had difficulty understanding responses to their questions, 22% wanted more time with the provider, 21% wanted more privacy, and 12% felt uncomfortable asking questions. Only 56% reported someone talked to them about HIV/AIDS. Strongest predictors of seeking inadequate ANC included low participant and partner education and lack of certain assets. Only 32% of women sought postnatal care. Some results varied by health zone.
Scaling-up interventions to improve reproductive health services should include broad-based health systems strengthening and promote equitable access to quality ANC, delivery, and postnatal services. Personal and structural-level barriers to seeking ANC need to be addressed, with consideration given to local contexts.
Url:
DOI: 10.1111/tmi.12171
PubMed: 23964667
PubMed Central: 3811924
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Bavon Mupenda<affiliation><nlm:aff id="A2">Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo</nlm:aff>
<wicri:noCountry code="subfield">Democratic Republic of Congo</wicri:noCountry>
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<affiliation><nlm:aff id="A2">Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo</nlm:aff>
<wicri:noCountry code="subfield">Democratic Republic of Congo</wicri:noCountry>
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Le document en format XML
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title>
<p id="P1">Increasing coverage of quality reproductive health services, including prevention of mother-to-child transmission services, requires understanding where and how these services are provided. To inform scale-up, we conducted a population-based survey in Kinshasa, Democratic Republic of Congo.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Stratified two-stage cluster sampling was used to select women ≥18 years old who had been pregnant within the prior three years. Participants were interviewed about their reproductive healthcare utilization and impressions of services received.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">We interviewed 1221 women, 98% of whom sought antenatal care (ANC). 78% of women began ANC after the first trimester and 22% reported <4 visits. Reasons for choosing an ANC facility included reputation (51%), friendly/accessible staff (39%), availability of comprehensive services (29%), medication access (26%), location (26%), and cost (21%). Most women reported satisfactory treatment by staff, but 47% reported that the ANC provider ignored their complaints, 23% had difficulty understanding responses to their questions, 22% wanted more time with the provider, 21% wanted more privacy, and 12% felt uncomfortable asking questions. Only 56% reported someone talked to them about HIV/AIDS. Strongest predictors of seeking inadequate ANC included low participant and partner education and lack of certain assets. Only 32% of women sought postnatal care. Some results varied by health zone.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Scaling-up interventions to improve reproductive health services should include broad-based health systems strengthening and promote equitable access to quality ANC, delivery, and postnatal services. Personal and structural-level barriers to seeking ANC need to be addressed, with consideration given to local contexts.</p>
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<aff id="A1"><label>1</label>
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA</aff>
<aff id="A2"><label>2</label>
Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo</aff>
<author-notes><corresp id="FN1">Corresponding author: Lydia Feinstein, The University of North Carolina at Chapel Hill, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599, USA. Phone +1-404-313-0987, Fax +1-919-966-2089, <email>lfeinst@email.unc.edu</email>
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<issue>10</issue>
<elocation-id>10.1111/tmi.12171</elocation-id>
<abstract><sec id="S1"><title>Objectives</title>
<p id="P1">Increasing coverage of quality reproductive health services, including prevention of mother-to-child transmission services, requires understanding where and how these services are provided. To inform scale-up, we conducted a population-based survey in Kinshasa, Democratic Republic of Congo.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Stratified two-stage cluster sampling was used to select women ≥18 years old who had been pregnant within the prior three years. Participants were interviewed about their reproductive healthcare utilization and impressions of services received.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">We interviewed 1221 women, 98% of whom sought antenatal care (ANC). 78% of women began ANC after the first trimester and 22% reported <4 visits. Reasons for choosing an ANC facility included reputation (51%), friendly/accessible staff (39%), availability of comprehensive services (29%), medication access (26%), location (26%), and cost (21%). Most women reported satisfactory treatment by staff, but 47% reported that the ANC provider ignored their complaints, 23% had difficulty understanding responses to their questions, 22% wanted more time with the provider, 21% wanted more privacy, and 12% felt uncomfortable asking questions. Only 56% reported someone talked to them about HIV/AIDS. Strongest predictors of seeking inadequate ANC included low participant and partner education and lack of certain assets. Only 32% of women sought postnatal care. Some results varied by health zone.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Scaling-up interventions to improve reproductive health services should include broad-based health systems strengthening and promote equitable access to quality ANC, delivery, and postnatal services. Personal and structural-level barriers to seeking ANC need to be addressed, with consideration given to local contexts.</p>
</sec>
</abstract>
<kwd-group><kwd>Antenatal Care</kwd>
<kwd>prevention of mother-to-child transmission of HIV</kwd>
<kwd>Democratic Republic of Congo</kwd>
<kwd>maternal and child health</kwd>
<kwd>household survey</kwd>
<kwd>implementation research</kwd>
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