Assessment of the Content and Utilization of Antenatal Care Services in a Rural Community in Cameroon: A Cross-Sectional Study


Background: Pregnant women receive antenatal care (ANC) to ensure favorable pregnancy outcomes. Despite the high ANC coverage rate registered nationally in Cameroon; rural women, women with no formal education and those in the most deprived quintile still face difficulties in having access to quality ANC. The impact of the aforementioned factors on ANC use in the Muea Health Area (MHA) is unknown. The objective of this study was to determine the proportion of women attending ANC and the factors influencing ANC attendance in the MHA. Materials and Methods: This was a community based, analytical, cross sectional survey that involved pregnant women and women with children less than two years old who gave an informed consent or assent. Data were collected using a semi structured questionnaire. EPI info Version 7 and Stat Pac for Windows version 12? 1998-2011 (Stat Pac Inc, Bloomington, USA) were used for data analysis. Associations were considered statistically significant for p values less than 0.05. Results: Two hundred and twenty women were interviewed. The mean age was 25 years (SD 5.28). Ninety-nine percent of women had at least one ANC visit meanwhile 84.8% had at least four ANC visits. Only 27.2% of women booked for ANC in the first trimester. Rural (Maumu) residence was associated with inappropriate ANC attendance (attending less than four times) (χ2 = 18.5; p = 0.001). Semi urban women (87%; 95% C.I. = 85.10% - 89.0%) were more likely to attend four or more sessions than rural (Maumu) women (60.7%; 95% C.I. = 44.2% - 77.3%) (p = 0.001). Participant’s educational level was a significant predictor of early booking for ANC (χ2 = 26.8; p = 0.0002). Semi urban wom- en (79.1%; 95% C.I. = 76.0% - 82.2%) were significantly more likely to have a vaginal examination done than rural (Maumu) women (42.1%; 95% C.I. = 17.5% - 68.2%) (p = 0.0001). Women who met a doctor during ANC (84.0%; 95% C.I. = 80.8% - 87.0%) were more likely to have a vaginal examination done than women who only met a nurse or a midwife during ANC (65.0%; 95% C.I. = 57.7% - 71.4%) (p = 0.002). One third of women did not have a vaginal examination performed during ANC. 45.83% and 47.6% neither did a stool test nor received an insecticide treated net (ITN) respectively. Conclusion: Women in the MHA start their antenatal care late, so they should be encouraged to book early for antenatal surveillance. Furthermore, efforts should be made to increase the access of these women to quality ANC services and to adequately trained ANC providers.

Share and Cite:

Halle-Ekane, G. , Obinchemti, T. , Nzang, J. , Mokube, N. , Njie, M. , Njamen, T. and Nasah, B. (2014) Assessment of the Content and Utilization of Antenatal Care Services in a Rural Community in Cameroon: A Cross-Sectional Study. Open Journal of Obstetrics and Gynecology, 4, 846-856. doi: 10.4236/ojog.2014.414119.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] United Nations (2011) The Millennium Development Goals Report 2011. United Nations, New York.
[2] Abou-Zhar, C.L. and Wardlaw, T. (2003) Antenatal Care in Developing Countries: Promises, Achievements, and Missed Opportunities: An Analysis of Trends, Levels, Differentials, 1990-2001. World Health Organization, Geneva.
[3] Villar, J. and Bergsjo, P. (2002) WHO Randomized Trial. Manual for the Implementation of the New Model. World Health Organisation, Geneva.
[4] Institut National de La Statistique, Ministère de la Planification de la Programmation du Développement et de L’Aménagement du Territoire & ORC Macro (2011) Enquête Démographique et de Santé et a Indicateurs Multiples IDSMICS. Rapport Préliminaire. INS, Yaoundé.
[5] Mafany, N.M., Mati, J.K.G. and Nasah, B.T. (1990) Maternal Mortality in the South West Province of Cameroon 1982-1987. Annuals’ Universitaires Sciences Santé, 7, 52-69.
[6] Fomulu, J.N., Ngassa, P.N., Nong, T., Nana, P. and Nkwabong, E. (2009) Mortalité Maternelle à la Maternité du Centre Hospitalier et Universitaire de Yaoundé, Cameroun: Etude Rétrospective de 5 ans (2002 à 2006). HSD, 10, 11-16.
[7] Fomulu, J.N., Tiyou, K.C., Mbu, R.E., Nana, N.P. and Leke, R.J.I. (2008) Mortalité Maternelle à la Maternité Principale de Yaoundé: Etude Rétrospective de 2001 à 2006. HSD, 9, 86-92.
[8] Optimizing the Use of Antenatal Care Services in Cameroon.
[9] WHO (2011) World Health Statistics 2011. WHO, Geneva.
[10] Buea District Health Service (2011) Total Population for the Year 2011, Buea. Buea District Health Services, Annual Report 2011.
[11] Bennett, S., Woods, T., Liyanage, W.M. and Smith, D.L. (1991) A Simplified General Method for Cluster Sample Surveys of Health in Developing Countries. World Health Statistics Quarterly, 44, 98-106.
[12] Buea District Health Service (2011) Population Distribution per Community, Buea. Buea Health District Services. Annual Report 2011.
[13] National Institute of Statistics, Ministry of the Economy, Planning and Regional Development (2008) Country Report on Progress in Achieving the Millennium Development Goals. Ministry of the Economy, Planning and Regional Development, Yaoundé.
[14] Buea Health District Service (2010) Report of Health Activities in Buea Health District January to March 2010. Buea Health District Service.
[15] Jimoh, A.A.G. (2003) Utilization of Antenatal Services at the Provincial Hospital Mongomo, Guinea Equatoria. African Journal of Reproductive Health, 7, 49-54.
[16] Van Eijk, A., Bles, H.M., Odhiambo, F., Ayisi, J.G., Blokland, E.I., Rosen, H.D., Adazu, K., Slutsker, L. and Lindblade, K.A. (2006) Use of Antenatal Services and Delivery Care among Women in Rural Western Kenya: A Community Based Study. Reproductive Health, 3, 2.
[17] Institut National de La Statistique, Ministère de la Planification de la Programmation, du Développement et de L’Aménagement du Territoire, ORC Macro (2004) Enquête Démographique et de Santé Cameroun. INS, Yaoundé.
[18] Dario, M.D. and Owoyokun, K.E. (2010) Factors Affecting the Utilization of Antenatal Care Services in Ibadan, Nigeria. Benin Journal of Post Graduate Medicine, 12, 3-13.
[19] Carlson, M., Paintain, L.S., Bruce, J., Webster, J. and Lines, J. (2011) Who Attends Antenatal Care and Expanded Programme on Immunization Services in Chad, Mali and Niger? The Implications for Insecticide Treated Net Delivery. Malaria Journal, 10, 341.
[20] Mbu, E.R., Kongnyuy, E.J., Mbopi-Keou, F.X., Tonye, R., Nana, P.N. and Leke, R.J.I. (2008) Gynaecological Morbidity among HIV Positive Pregnant Women in Cameroon. Reproductive Health, 5, 3.
[21] Tann, C.J., Kizza, M., Morison, L., Mabey, D., Muwanga, M., Grosskurth, H. and Elliott, A.M. (2007) Use of Antenatal Services and Delivery Care in Entebbe, Uganda: Community Survey. BMC Pregnancy and Child Birth, 7, 23.
[22] Kiwuwa, M. and Mufubenga, P. (2008) Use of Antenatal Care, Maternity Services, Intermittent Preventive Treatment and Insecticide Treated Bed nets by Pregnant Women in Luwero District, Uganda. BMC Pregnancy and Childbirth, 7, 44.
[23] Ali, A.A., Osman, M., Abbaker, A.O. and Adam, I. (2010) Antenatal Care Services in Kassala, Eastern Sudan. BMC Pregnancy & Childbirth, 10, 67.
[24] Anchang-Kimbi, J.K., Achidi, E.A., Nkegoum, B., Sverremark-Ekstrom, E. and Troye-Bloomberg, M. (2009) Diagnostic Comparison of Malaria Infection in Peripheral Blood, Placental Blood and Placental Biopsies in Cameroonian Parturient Women. Malaria Journal, 8, 126.
[25] Takem, E.N., Achidi, E.A. and Ndumbe, P.M. (2009) Use of Intermittent Preventive Treatment for malaria by Pregnant Women in Buea, Cameroon. Acta Tropica, 112, 54-58.
[26] Mosima, E. (2011) Government to Open 8 Schools for Midwifery Training This Year. Cameroon Tribune.
[27] Oladapo, T.O., Iyaniwura, C.A. and Sule-Odu, A.O. (2008) Quality of Antenatal Care services at the Primary Care Level in South Western Nigeria. African Journal of Reproductive Health, 12, 71-92.
[28] Gross, K., Schellenberg, J.A., Kessi, F., Pfeiffer, F. and Obrist, B. (2011) Antenatal Care Practices. An Exploratory Study in Antenatal Care Clinics in the Kilombero Valley, South Eastern Tanzania. BMC Pregnancy and Childbirth, 11, 36.
[29] Ouma, P.O., Van Eijk, A.M., Sikuku, E.S., Odhiambo, F.O., Crawdord, S.B., Ayisi, J.G., Kager, P.A. and Slutsker, L. (2010) Antenatal and Delivery Care in Rural Western Kenya: The Effect of Training Health Workers to Provide “Focused Antenatal Care”. Reproductive Health, 7, 1.

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.