Use of Antenatal Care Services and Presumptive Malaria During Pregnancy in San, Mali

Introduction: Antenatal care (ANC) is valuable in the fight against maternal mortality. It prevents or treats complications related to pregnancy and/or childbirth. To assess the use of ANC services by pregnant women with presumptive malaria, we conducted a cross-sectional study. 

Methods: The study was conducted from 03 to 21 November 2019 in San health district. Our study concerned women of childbearing age with a child less than 6 months old and residing in the San health district at the time of the survey. Data were collected using Open Data Kit (ODK) version 1.29.2 and analysed in R version 3.6.3. 

 Results: The study included 2195 participants, but for the assessment of antenatal care attendance, data from 1814 women was analysed. The average age of the participants was 25.8 years with extremes ranging from 15 to 47 years. Almost all participants were married (97.41%) and 59.91% were uneducated. Our data shows that 80.7% of participants used at least one ANC. Those living in households headed by an employee (OR= 9.10; p<0.002) or a shopkeeper (OR= 2.26; p<0.001) were more likely to attend ANC. Participants with primary education (OR= 2.04; p<0.042) or Arabic education (OR=1.80; p<0.043) were also more likely to attend ANC. The high cost of ANC, refusal of the husband and preference of traditional birth attendants over medical providers were the main barriers listed by women who did not use ANC services.  

Conclusion: Nearly 77% of our study participants had received at least one dose of IPTp-SP. Lack of financial means and low level of education were identified as barriers to attending antenatal care services. More than half of the suspected malaria cases were observed in primigravidae women. 

 Keywords: Antenatal care, Malaria, pregnancy, San, Mali.