Spatial Distribution and Predictive Factors of Antenatal Care in Burundi

Abstract Background : The use of obstetric care by pregnant women enables them to receive antenatal and postnatal care. This care 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. This study deals with the spatial analysis of antenatal care (ANC) among women aged 15 to 49 with a doctor and associated factors in Burundi. Methods: Data were obtained from the second Demographic and Health Survey (DHS) carried out in 2010. A spatial analysis of the prevalence of ANC made it possible to map this prevalence by region and province, and to interpolate the cluster-based ANC prevalence at unsampled data points using the kernel method with an adaptive window. The dependent variable is the antenatal care (yes / no) with a doctor and the explanatory variables are place of residence, age, level of education, religion, marital status of the woman, the quintile of economic well-being of the household and place of birth of the woman. Factors associated with ANC were assessed using binary mixed logistic regression. Data were analyzed using R software, version 3.5.0. Results: The findings of this study clearly show that ANC prevalence varies from 0 to 16.2% with a median of 0.5%. A pocket of prevalence was observed at the junction between Muyinga and Kirundo provinces. Low prevalence was observed in several locations in all regions of the provinces. They also show that woman’s education level and place of delivery are significantly associated with antenatal care. Conclusion: Prevalence of ANC is not the same across the country. It varies between regions and provinces. Besides, there is intra-regional or intra-provincial heterogeneity in the prevalence of ANC.