Predictors of Skilled Birth Attendance Among Women of Reproductive Age in the Democratic Republic of the Congo (Drc): An Analysis of Secondary Data From Drc’s 2013-2014 Demographic and Health Survey (Dhs)

Background: Maternal mortality is still high in the Democratic Republic of the Congo. Evidence showed that access to skilled birth attendance (SBA) is a key factor in reducing maternal mortality in developing countries. However, previous studies also showed that access to SBA in developing countries is not universal. This study aims to assess SBA prevalence and associated factors among women of reproductive age in the DRC. Methods: The study population included women aged 15-49 years with a history of at least one delivery. We analyzed a sample of 18302 women from the DRC’s 2013-2014 DHS. We applied both bivariate and multivariate logistic regressions to identify predictors of SBA in the DRC. We presented the crude odds ratios, the adjusted odds ratios and the 95% confidence intervals. Results: We found that 80.1% of women had access to SBA in the DRC. After adjusting our models for potential confounders, we identified the following predictors of SBA in the DRC: antenatal care (ANC) (OR= 8.5, 95% CI = 6.4-11.3), maternal education (OR=1.9, 95%CI=1.4-2.5), urban residence (OR=1.7, 95%CI=1.1-2.5), wealth (OR= 12.7, 95% CI=4.9-32.5), husband/partner’s occupation (OR=6.3, 95% CI=1.7-23.7) and protection against domestic violence (OR=1.4, 95% CI=1-1.8). Moreover, we found that the lowest odds of accessing SBA were found among residents of Katanga province (OR=0.1, 95% CI = 0-0.4), Equateur province (OR=0.3, 95% CI=0.1-0.6) but also among military wives (OR=1.5, 95%CI=0.6-4.1) and farmers’ wives (OR=1.4, 95%CI=0.6-3.1). Conclusions: This study confirms that retention in skilled maternity continuum of care through skilled antenatal care contributes to increased SBA. Our findings demonstrate that retention in SBA is likely to occur when women are educated, lifted out of poverty and protected from domestic violence. We also conclude that women who are less likely to attend SBA can be identified during ANC visits using data on maternal education, wealth index, place of residence and domestic violence. We therefore recommend: - interventions that promote girl-child education, Gender-Based Violence (GBV) control and poverty alleviation.