Bridging the Gap Evaluating Antenatal Care Quality in Kamina’s UrbanRural Divide

Introduction

Access to quality antenatal care is a fundamental right and necessity for every pregnant woman. In the Democratic Republic of Congo, particularly in Kamina, disparities in care quality across urban and rural settings have led to significant maternal health challenges. This recent study published in the Clinical Journal of Obstetrics and Gynecology highlights the determinants of inadequate antenatal consultations and suggests ways to improve maternal care services.
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Findings at a Glance

• 476 mothers were surveyed across six healthcare facilities in Kamina.
• Only 27.5% of antenatal consultations were deemed adequate based on frequency, screening, and prophylaxis standards.
• 72.5% of women received inadequate care.
• Key determinants of inadequate care included:
  • Low maternal education (aOR = 3.93)
  • Attendance at first-level health facilities (aOR = 3.22)
  • Multiple pregnancies (aOR = 1.82)

Read the full study at: https://doi.org/10.29328/journal.cjog.1001136

Why It Matters

According to the World Health Organization (WHO), nearly 99% of maternal deaths occur in low-resource settings and are preventable. The study’s findings reaffirm the critical need to enhance antenatal services, particularly in under-resourced regions like Kamina.

In Kamina:

• 40.3% of women had the recommended 4 ANC visits.
• Just 21.2% began ANC before 16 weeks gestation.
• Only 9.6% received the full recommended dosage of anti-malarial prophylaxis.

These numbers highlight systemic issues in maternal healthcare delivery, impacting both short term and long-term maternal fetal outcomes.

Screening and Prophylaxis Shortcomings

• Fetal heart rate: 93.1%
• Fundal height: 92.0%
• Blood pressure: 81.1%
• Malaria RDT: 65.6%
• HIV testing: Only 22.5%
• Syphilis screening: Only 15.3%

Prophylaxis Findings:

• Sulfadoxine-Pyrimethamine provided: 83.6%
• But only 9.6% completed ≥3 doses on time.
• Tetanus vaccination: 74.4%
• Iron & folic acid supplementation: 94.7%
• Deworming: 77.9%

These data indicate an urgent need to strengthen resource availability and protocol adherence across all care levels.

Systemic Barriers to Quality ANC

The research underscores how lower-tier health facilities often lack the infrastructure and expertise required for comprehensive maternal care. The issue is not just logistical but deeply linked to socioeconomic inequities:

• Mothers with less than secondary education were nearly four times more likely to receive inadequate ANC.
• First-level health facility attendees were three times more likely to receive substandard care.
• Multigravida women were less likely to prioritize early and regular ANC.

The American College of Obstetricians and Gynecologists (ACOG) also emphasizes that equitable care delivery and education access are pivotal to reducing maternal mortality rates globally.

Further Reading and Resources

A detailed analysis can be found in our main journal article.

Explore similar topics in our Obstetrics and Gynecology journal section.

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