Abstract
Objectives: to assess the influence of social status of women on their attendance at antenatal care (ANC) in North Benin context in 2016. Methods: A cross-sectional study was conducted from November 17th to December 16th, 2016 on a sample of 465 women who had delivered in the past few days before the survey. A structured and pre-tested questionnaire was used to collect information concerning their socio-demographic, socio-cultural, individual and community resources, and pregnancy complications. Results: Factors influencing the attendance at ANC in both univariate and multivariate analysis were number of pregnancy, the parity, the existence of a pathological obstetric history, the relationship with the head of household, the decision-making power to attend ANC, profession, income, woman's knowledge of ANC and some organizational factors (appropriateness of appointment days and waiting time). So, controlling for others factors and relative to women with the first pregnancy, women with the fifth pregnancy had 51.572 fold (95%IC=[7.93 – 335.28]) higher odd to be non attendance to antenatal care. Conclusion: Sociocultural, political and institutional factors should be taken into account in order to improve women’s attendance at antenatal care in North Benin.
Highlights
The variables that influence attendance at Antenatal care (ANC) in both univariate and multivariate analysis are number of pregnancy, the parity, the existence of a pathological obstetric history, the relationship with the head of household, the decision-making power to attend ANC, profession, income, woman's knowledge of ANC and organizational factors. By analyzing these decisive factors of women’s attendance at ANC in Parakou, we see that they are women who have an income (> or = 40 000FCFA), who have a good knowledge of ANC, who has got a desired pregnancy and the decision-making power to attend or not ANC
Titaley et al [8] at Java-Bali in Indonesia, found the role of social status. These authors found the high rank of the child in the siblings and the short interval inter-reproductive, factors referring to the parity and access to a contraceptive method by the woman; if the second factor is not formally found in our study, the role of parity in our study goes in the same direction
These capitals which are economic, cultural and social structure their membership in groups or social classes that in return explain their lifestyle or behavior in society. This means that in our context in Parakou, income, occupation and knowledge of ANC draw women belonging to a social group or a social class that determines their behavior vis-à-vis the attendance at ANC
Summary
In Benin, as well as in several other sub-Saharan African countries [2], the maternal mortality ratio was 405 per 100,000 live births according to WHO [3] and makes the country one of the major contributor to the worldwide death toll of mothers. The problem of maternal and perinatal deaths persists primarily due to insufficient skilled maternal antenatal care. The WHO recommends all women should accede to antenatal care during pregnancy, skilled care during childbirth, and care and support during early postpartum. And skilled management and treatment of risks ensure safe pregnancy and childbirth. In countries with limited resources where the number of antenatal visits is already low, reduced antenatal visits is associated with an increased perinatal mortality as compared to standard care [4].
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