Factors associated with incomplete prenatal care: A multilevel comparative analysis of data from the demographic and health surveys of Burkina Faso and Mali

Abstract

Prenatal care (PNC) constitutes a platform for providing important health services, including health  promotion,  screening,  diagnosis,  and  disease  prevention.  It  serves  to  identify  risks,  prevent, and manage pathologies related to or discovered during pregnancy. The objective of this  study  is  to  determine,  beyond  individual  characteristics,  the  contextual  factors  that  influence the completeness of prenatal care, while conducting a comparative analysis of these factors in two neighboring countries sharing a similar sociocultural and politico-health context. The  multilevel  logistic  regression  model  was  used  to  determine  the  factors  associated  with  incomplete PNC in both countries. The prevalence of incomplete PNC was 26.69% for Burkina Faso and 42.99% for Mali. Respectively, 14.51% and 20.50% of the variation in incomplete prenatal care among women is attributable to enumeration areas. After adjustment, the analysis showed  a  significant  decrease  in  the  risk  of  incomplete  prenatal  care  (PNC)  when,  in  both  countries, women were between 25 and 49 years old, their partners had a secondary education or  higher,  they  were  wealthy,  and  distance  from  a  health  center  was  a  problem.  This  study  concludes that there are common factors in both countries that influence the completeness of PNC. Therefore, it is important to combat poverty, promote education, and reduce inequalities in health coverage to improve women's access to PNC.