Social and Cultural perceptions of Antenatal Care among Pregnant Women and Their Husbands in Maniema Province, Democratic Republic of the Congo

José ASSANI TUTU; Ramazani Imani; Léon Cyprien Ngandu wa  Ngandu; Marie claire Omanyondo  Ohambe

doi:10.4314/rasp.v8i1.13

Authors

José ASSANI TUTU ISTM KINDU
Ramazani Imani Chaire de Recherche Sciences Infirmières USPN
Léon Cyprien Ngandu wa Ngandu Université de Kisangani
Marie claire Omanyondo Ohambe Institut Supérieur des Techniques Médicales Kinshasa ; Ville de Kinshasa, province de Kinshasa

DOI:

https://doi.org/10.4314/rasp.v8i1.13

Keywords:

Antenatal care, social and cultural perceptions, pregnant women, husbands

Abstract

Antenatal care is a fundamental component of reproductive health and a key lever for reducing maternal and neonatal morbidity and mortality. This study, conducted in Maniema Province, aims to analyse social and cultural perceptions of antenatal care to identify factors that facilitate or hinder its utilisation and to propose strategies tailored to the local context. A qualitative approach was adopted, based on semi-structured interviews and focus group discussions with pregnant women and their husbands, enabling triangulation of perspectives. The findings reveal an ambivalent perception of antenatal care. On the one hand, it is recognized as beneficial for pregnancy monitoring, complication prevention, and the protection of both mother and child. On the other hand, certain traditional beliefs consider antenatal care unnecessary, viewing pregnancy as a natural phenomenon that can be managed through traditional care or prayer. Husbands, who are often the primary decision-makers, play a central role in access to care: their support facilitates attendance, whereas modesty, fear of HIV testing, or the delegation of responsibility to women limit their involvement. The influence of in-laws, religious leaders, and peers is also significant. Strengthening peer education, promoting male involvement, implementing community-based campaigns, and engaging religious leaders emerge as key strategies for improving the utilization of antenatal care.

Downloads

Download data is not yet available.

References

Foglabenchi LH, Marchant T & Stöckl H (2025). Beyond ‘Go and bring your husband’: a COM-B guided qualitative study on the barriers to male involvement in antenatal care in Bamenda Health District, Cameroon. PLOS Global Public Health 5(5): e0002904. ,

Alhassan, N. (2024). Health care and contraceptive decision-making autonomy and use of female sterilisation among married women in Malawi. Frontiers in Global Women’s Health, 5, Article 1264190.

Bancalari, A., Bernal, P., García, M. F., Ibarrarán, P., Sánchez-Monin, E., & Zúñiga Brenes, P. (2024). Using subsidies to enhance access to maternal and newborn health care in remote villages (IDB Working Paper No. IDB-WP-01602). Inter-American Development Bank. https://doi.org/10.18235/0013208

Bobo, F. T., Asante, A., Woldie, M., Dawson, A., & Hayen, A. (2023). Evaluating equity across the continuum of care for maternal health services: analysis of national health surveys from 25 sub-Saharan African countries. International Journal for Equity in Health, 22, 239. https://doi.org/10.1186/s12939-023-02047-6

Chatata, A. G. (2025). The impact of multidimensional poverty on antenatal care service utilisation in Malawi. Health Economics Review, 15(1), Article 1.

Bourdieu, P. (1998). La domination masculine. Paris : Seuil.

Connell, R. W. (1995). Masculinities. Berkeley: University of California Press.

Connell, R. W., & Messerschmidt, J. W. (2005). Hegemonic masculinity: Rethinking the concept. Gender & Society, 19(6), 829-859.

Drabo, K. M., Tinto, H., Hien, H., Konfé, S., Nana, F., Ly, A., & Ouédraogo, T. L. (2024). Perceptions des femmes enceintes fréquentant la consultation prénatale dans les centres de santé de premier échelon du District sanitaire de Do et Dafra au Burkina Faso. Sciences de la Santé, 38(1–2).

Felana, A. Ihantamalala. (2025). Persistent geographic barriers to maternal care services following a health system strengthening initiative in rural Madagascar. BMC Pregnancy and Childbirth.

Foglabenchi, L. H., Stöckl, H., & Marchant, T. (2024). ‘I am a father but not pregnant’: a qualitative analysis of the perspectives of pregnant couples on male partner role during pregnancy care in Bamenda, Cameroon. Reproductive Health, 21, Article 195.

Frontiers et al. (2024) « Effectiveness of engaging religious leaders in maternal health education for improving maternal health service utilization in Ethiopia: cluster randomized controlled trial »

Gessesse, N. A., Gela, G. B., Aweke, A. M., Beyene, F. Y., Kassahun, E. A., Getu, A. A., … & Balcha, W. F. (2024).

Male partners’ involvement in antenatal care and its associated factors in West-central Ethiopia. BMC Public Health, 24, 3015. https://doi.org/10.1186/s12889-024-20502-z

Gökçen Çeliker. (2024). Evaluation of differences in maternal and newborn health coverage across urban and rural areas: A pooled analysis of 88 countries. Turkish Journal of Public Health, 22(1), 13–22.

Hailu, M., Mohammed, A., Sintayehu, Y., Tadesse, D., Abera, L., Abdurashid, N., Solomon, M., Ali, M., Mellese, D., Weldeamaniel, T., Mengesha, T., Hailemariyam, T., Amsalu, S., Dejene, Y. & Girma, M. (2023). Cultural malpractice during pregnancy, childbirth, and the postnatal period and its associated factors among women who gave birth once in Dire Dawa city administration, Eastern Ethiopia, in 2021. Frontiers in Global Women’s Health, 4, 1131626. https://doi.org/10.3389/fgwh.2023.1131626

Hibusu, L., Sumankuuro, J., Gwelo, N. B. & Akintola, O. (2024). Pregnant women’s satisfaction with the quality of antenatal care and the continued willingness to use health facility care in Lusaka district, Zambia. BMC Pregnancy and Childbirth, 24, 20. https://doi.org/10.1186/s12884-023-06181-5

Ilunga Mbayo, F., Madragule, P. G., Kanku wa Ilunga, P., Bwana Kangulu, I., & Nkamba Mukadi, D. (2025). Quality of First Prenatal Consultations in Malemba Nkulu, Democratic Republic of Congo: Challenges and Opportunities in a Cross-Sectional Study. JMIR Pediatrics and Parenting.

Jacobson, L. E., Fuentes-Rivera, E., Schiavon, R., & Darney, B. G. (2023). Association of maternal age 35 years and over and prenatal care utilization, preterm birth, and low birth weight, Mexico 2008–2019. International Journal of Gynecology & Obstetrics.

Kota, K., Chomienne, M.-H., Geneau, R., & Yaya, S. (2023). Socio-economic and cultural factors associated with the utilization of maternal healthcare services in Togo: a cross-sectional study. Reproductive Health, 20(1), Article 109.

Nyando, M., Makombe, D., Mboma, A., Mwakilama, E. & Nyirenda, L. (2023). Perceptions of pregnant women on antenatal care visit during their first trimester at Area 25 Health Centre in Lilongwe, Malawi – a qualitative study. BMC Women’s Health, 23, 646. https://doi.org/10.1186/s12905-023-02800-7

Lwanga, H., Atuyambe, L., Sempewo, H., Lumala, A. & Byaruhanga, R. N. B. (2017). An exploratory study of men’s companionship, perceptions and experiences during pregnancy and delivery in Uganda. BMC Pregnancy and Childbirth, 17, 196. https://doi.org/10.1186/s12884-017-1385-6

Mbua, E. K., Karonjo, J., Okova, R., & Gachathi, D. (2024). Health Facility Determinants of Male Partner Involvement in Antenatal Care in Kiambu County, Kenya. Kenyan Journal of Nursing & Midwifery.

Mudonhi, N., & Nunu, W. N. (2022). Traditional medicine utilisation among pregnant women in Sub-Saharan African countries: A systematic review of literature. Inquiry, 59, 469580221088618. https://doi.org/10.1177/004695802210886

Ndela, B., N’siala, A., Ngwala, P., Kalonji, A., Minuku, F., Bokole, H., Kemaina, P., Masumbuku, J.-J., & Miezi-Kintaudi, N. (2024). Knowledge and practice of health workers towards maternal and child health in the Democratic Republic of the Congo: a cross-sectional study. Reproductive Health, 21, 62. https://doi.org/10.1186/s12978-024-01801-5

Nesane, K. V. & Mulaudzi, F. M. (2024). Cultural barriers to male partners’ involvement in antenatal care in Limpopo province. Health SA Gesondheid, 29, a2322. https://doi.org/10.4102/hsag.v29i0.2322

Ngowi, A. F., Mkuwa, S., Shirima, L., Ngalesoni, F., & Frumence, G. (2023). Determinants of Focused Antenatal Care Utilization Among Women in Simiyu Region, Tanzania. SAGE Open Nursing, 9.

Okyere, J., Zenbaba Hey, D., & Yaya, S. (2025). Influence of paternal education on maternal and child health outcomes in Sub-Saharan Africa: evidence from demographic and health surveys. Reproductive Health, 22, 137.

Olawore, O., Abiodun, A., & Oyeyemi, S. (2025). Visible and invisible cultural patterns influencing women’s use of maternal health services among Igala women in Nigeria: A focused ethnographic study. BMC Public Health, 25.

Onah, M. N., Onah, R. C., & Onah, F. E. (2023). Linkages between women’s empowerment, religion, marriage type, and uptake of antenatal care visits in 13 West African countries. PLOS Global Public Health, 3(6), e0000406.

Opara, U. C. (2024). Cultural and religious structures influencing the use of maternal health services in Nigeria: A qualitative study using the PEN-3 cultural model. Reproductive Health, 21(1), Article 93. 2978- https://doi.org/10.1186/s1024-01933-8

Organisation mondiale de la Santé. (2022). Recommandations sur les soins prénatals pour une expérience positive de la grossesse. OMS.

Daniele, M. A. S. (2021). Male partner participation in maternity care and social support for childbearing women: a discussion paper. Philosophical Transactions of the Royal Society B: Biological Sciences, 376(1827), 20200021. https://doi.org/10.1098/rstb.2020.0021

Pizarro, J. & Gartzia, L. (2024). Paternity leave: a systematic review and research directions. Human Resource Management Review, 34(1), 101001. https://doi.org/10.1016/j.hrmr.2023.101001

Ramazani, I. B. E., Ntela, S. D. M., Ahouah, M., Ishoso, D. K. & Tondeur, M. R. (2022). Maternal mortality in Eastern Democratic Republic of the Congo: analysis of health facility data. BMC Pregnancy and Childbirth, 22, 452. https://doi.org/10.1186/s12884 022 04783 z

Sadore, A. A., Kebede, Y. & Birhanu, Z. (2024). Effectiveness of engaging religious leaders in maternal health education for improving maternal health service utilization: a cluster randomized controlled trial. PLOS ONE, 19(4), e0296173. https://doi.org/10.1371/journal.pone.0296173

Souza, J. P., Day, L.-T., Rezende-Gomes, A.-C., Zhang, J., Mori, R., Baguiya, A., Jayaratne, K., Osoti, A., Vogel, J. P., Campbell, O., Mugerwa, K. Y., Lumbiganon, P., Tunçalp, Ö., Cresswell, J., Say, L., Moran, A. C., & Oladapo, O. T. (2024). A global analysis of the determinants of maternal health and transitions in maternal mortality.

Tamir, T. T., et al. (2024). Determinants of non-testing for HIV among women during antenatal care in sub-Saharan Africa. BMC Health Services Research.

Tengera, O., Meharry, P., Nkurunziza, A., Babenko Mould, Y., Rugema, J., Rulisa, S. & Nyirazinyoye, L. (2025). Barriers hindering attendance and adherence to antenatal care visits among women in rural areas in Rwanda: an exploratory qualitative study. PLOS ONE, 20(5), e0323762. https://doi.org/10.1371/journal.pone.0323762

Tumwizere, G., Mbonye, M. K., & Ndugga, P. (2024). Determinants of late antenatal care attendance among high parity women in Uganda: analysis of the 2016 Uganda Demographic and Health Survey. BMC Pregnancy and Childbirth, 24(1), 32.

Warri, D., & George, A. (2020). Perceptions of pregnant women of reasons for late initiation of antenatal care: a qualitative interview study. BMC Pregnancy and Childbirth, 20(70). https://doi.org/10.1186/s12884-020-2746