Social Representations of Antenatal Care (ANC) and the Use of Traditional Medicine During Pregnancy in Maniema Province, DRC
Keywords:
Antenatal care, Traditional medicine, social representations, Pregnancy, Maniema Province, DRCAbstract
Antenatal care is a key intervention for reducing maternal and neonatal mortality. However, its utilization remains strongly influenced by sociocultural, economic, and symbolic factors that are often insufficiently explored in African contexts. This study aimed to analyze social representations of ANC and associated practices in Maniema Province. A qualitative, exploratory study using a phenomenological approach was conducted in 2024 across four health zones (Kindu, Alunguli, Kalima, and Kunda). A purposive sampling strategy combined with theoretical sampling included 45 participants (pregnant women, husbands, traditional healers, healthcare providers, and religious leaders). Data were collected through semi-structured interviews, focus group discussions, and direct observation, and analyzed using a thematic approach inspired by social representations theory. ANC is perceived as a marker of modernity but also as an ambivalent space, oscillating between protection and mistrust. Pregnancy is socially constructed as a period of vulnerability requiring care and supervision. The use of traditional medicine reflects cultural continuity and a search for meaning, illustrating therapeutic pluralism. Care-seeking behaviors are influenced by family dynamics, spirituality, and the quality of interactions with healthcare providers. Economic and organizational barriers further limit access to ANC services. ANC utilization results from a complex interaction of sociocultural and structural factors. A woman-centred, culturally sensitive, and integrated approach is needed to improve the use of maternal health services.
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