Low antenatal care utilization among multiparous women in Mbuji-Mayi, Democratic Republic of the Congo: prevalence and associated factors

Background: Antenatal care is essential for preventing pregnancy complications and improving maternal and neonatal outcomes. However, low utilization of antenatal care services remains a major public health problem in many low- and middle-income countries, particularly among multiparous women who often perceive pregnancy as a routine event. Objective: This study aimed to determine the prevalence of low antenatal care utilization and identify associated factors among multiparous women in Mbuji-Mayi, Democratic Republic of the Congo. Methods: A community-based cross-sectional study was conducted among multiparous women. Data were collected using structured questionnaires and analyzed using descriptive statistics and logistic regression. Odds ratios and 95% confidence intervals were calculated to assess associations between independent variables and low antenatal care utilization, and multivariate logistic regression was performed to identify factors independently associated with low antenatal care utilization. Results: The prevalence of low antenatal care utilization was 33.6%. In multivariate analysis, low education level (AOR = 1.77; 95% CI: 1.15–2.73; p = 0.010), unmarried marital status (AOR = 2.63; 95% CI: 1.18–5.86; p = 0.018), living at least 5 km from a health facility (AOR = 1.85; 95% CI: 1.19–2.88; p = 0.006), and lack of knowledge about the recommended number of antenatal care visits (AOR = 2.09; 95% CI: 1.37–3.20; p = 0.001) were independently associated with low antenatal care utilization. Conclusion: Low antenatal care utilization remains a significant public health problem among multiparous women in Mbuji-Mayi. Interventions should focus on improving women’s education, increasing awareness of recommended antenatal care visits, strengthening social support during pregnancy, and improving geographical access to maternal health services.