Factors associated with late onset of antenatal care in the Drodro Health Zone, Ituri Province, Democratic Republic of the Congo

Abstract

Context and objective. Antenatal care (ANC) is essential for reducing maternal and infant mortality. However, in the majority of low-income countries, ANC begins late. This study aimed at identifying the factors associated with late onset of ANC. Methods. An analytic cross-sectional study was conducted from October 1 to December 31, 2024, involving pregnant women selected using probability sampling. Sociodemographic and gyneco-obstetrical data were collected by interview. Binary logistic regression was performed to determine factors associated with late onset of ANC, in the Drodro health zone, Ituri province, in the Democratic Republic of Congo (DRC). Results. A total of 288 women participated in the study. More than seven out of ten started ANC late (77.4%, 95% CI = 72.2-82.1). Factors associated with this delay were inadequate knowledge of the age of onset of ANC (adjusted OR = 3.66; 95% CI: 1.74-7.69), low spousal involvement in ANC (OR = 2.79; 95% CI: 1.38-5.63), and opposition to early pregnancy disclosure (OR = 2.74; 95% CI: 1.42-5.30). Conclusion. Delayed onset of ANC is common, particularly among women who do not know the age at which ANC should begin, those whose partners are not involved in ANC, and those who are opposed to early disclosure of their pregnancy status. Thus, interventions aimed at improving women's knowledge of ANC and involving male partners in ANC activities can help to address this issue.

Received October 14, 2025

Accepted 25 mars, 2026

https://dx.doi.org/10.4314/aamed.v19i3.5