Spatial distribution and predictive factors of antenatal care in Burundi: A spatial and multilevel baseline analysis for the third burundian demographic and health survey

Abstract

Introduction The use of antenatal care by pregnant women enables them to receive good pregnancy monitoring. This monitoring includes counseling, health instructions, examinations and tests to avoid pregnancy-related complications or death during childbirth. To avoid these complications, the World Health Organization (WHO) recommends at least four antenatal visits. Therefore, this study was conducted to identify predictive factors of antenatal care (ANC) among women aged 15 to 49 years and its spatial distribution in Burundi. Methods We used data from the Second Burundi Demographic and Health Survey (DHS). A Spatial analysis of ANC prevalence and Mulitlevel logistic regressions of determinants factors of ANC with a medical doctor were done. The ANC prevalence was mapped by region and by province. In unsampled data points, a cluster based interpolation of ANC prevalence was done using the kernel method with an adaptive window. Predictive factors of ANC were assessed using Mulitlevel logistic regressions. The dependent variable was antenatal care with a medical doctor and the explanatory variables were place of residence, age, education level, religion, marital status of the woman, household wealth index and delivery place of the woman. Data processing and data analysis were done using using Quantum Geographic Information System (QGIS) and R software, version 3. 5. 0. Results The ANC prevalence varied from 0. 0 to 16. 2% with a median of 0. 5%. A highest predicted ANC prevalence was observed at Muyinga and Kirundo provinces’ junction. Low prevalence was observed in several locations in all regions and provinces. The woman’s education level and delivery place were significantly associated with antenatal care with a medical doctor. Conclusion Globally, the ANC prevalence is low in Burundi. It varies across the country. There is an intra-regional or intra-provincial heterogeneity in term of ANC prevalence. Woman’s education level and delivery place are significantly associated antenatal care. There is a need to consider these ANC disparities and factors in the design and strengthening of existing interventions aimed at increasing ANC visits.

Muslim and Christian Women’s Perceptions of the Influence of Spirituality and Religious Beliefs on Motherhood and Child-Rearing: A Phenomenological Study

“…However, Christian women are more likely to partake in these programs while Muslim women place more value on the knowledge transmitted to them by their mothers and women in their families. This result agrees with that of other studies in which Christian women were more likely to use the services of skilled midwives in Guinea [56]; this is also a proven fact in the case of Muslims in sub-Saharan Africa [57], India [58], Bangladesh [59], Ethiopia [60], and Nigeria [61], but not those in Burundi [62].…”

“…Nevertheless, Muslim women who attended prenatal classes before giving birth for the first time stated that these classes gave them practical tools to prepare for labor and delivery, and found them helpful in providing reassurance about giving birth, relieved their fears, prepared them psychologically, and made them feel more comfortable about what the experience might entail [62]. As mentioned before, those who did not attend prenatal classes found the information they needed in consultation with family [63].…”

A Scoping Review on Influence of Socioeconomic Status on Antenatal Care Utilization and Pregnancy Outcomes in Sub-Saharan Africa

“…Despite antenatal care (ANC), delivery and postnatal care being free at the point of use in Burundi, utilization of these services remains low: between 2011 and 2017, only 49% of pregnant women attended at least four ANC visits [20]. Some of the factors identified in this study suggested that factors such as women’s education, their husbands’ education level, where they live, whether they plan to become pregnant, family income, and the household wealth index are factors that influence whether they used antenatal care [19].…”

“…The prevalence of Antenatal visits in Burundi is majorly below 6%, only the region of Bujumbura-Mairie has the highest ANC prevalence (24. 6%) and the lowest is in the West region (2.7%) [19]. Despite antenatal care (ANC), delivery and postnatal care being free at the point of use in Burundi, utilization of these services remains low: between 2011 and 2017, only 49% of pregnant women attended at least four ANC visits [20].…”