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Antenatal and delivery services in K inshasa, D emocratic R epublic of C ongo: care‐seeking and experiences reported by women in a household‐based survey
Author(s) -
Feinstein Lydia,
Dimomfu Bruno Lapika,
Mupenda Bavon,
Duvall Sandra,
Chalachala Jean Lambert,
Edmonds Andrew,
Behets Frieda
Publication year - 2013
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12171
Subject(s) - reproductive health , medicine , psychological intervention , family medicine , population , health care , partner notification , nursing , environmental health , human immunodeficiency virus (hiv) , economics , economic growth , syphilis
Objectives 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 K inshasa, D emocratic R epublic of C ongo. Methods 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. Results 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. Conclusions 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.