@article{fdi:010082430,
  title = {{F}actors influencing maternal healthcare seeking in a highland region of {M}adagascar : a mixed methods analysis},
  author = {{A}ndrianantoandro, {V}.{T}. and {P}ourette, {D}olor{\`e}s and {R}akotomalala, {O}. and {R}amaroson, {H}.{J}.{V}. and {R}atovoson, {R}. and {R}akotoarimanana , {F}.{M}.{J}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {I}n {M}adagascar, maternal mortality remains stable and high (426 deaths per 100,000 live births). {T}his situation is mainly due to a delay or lack of use of maternal healthcare services. {P}roblems related to maternal healthcare services are well documented in {M}adagascar, but little information related to maternal healthcare seeking is known. {T}hus, this paper aims to identify and analyze the factors that infuence the utilization of maternal services, specifically, the use of antenatal care ({ANC}) during pregnancy and the use of skilled birth attendants ({SBA}s) at delivery. {M}ethod: {W}e used quantitative and qualitative approaches in the study. {T}wo communes of the {V}akinankaratra region, which are located in the highlands, were the settings. {D}ata collection occurred from {O}ctober 2016 to {J}uly 2017. {A}  total of 245 pregnant women were included and followed up in the quantitative survey, and among them, 35 participated in in-depth interviews ({IDI}s). {L}ogistic regressions were applied to explore the infuencing factors of antenatal and delivery healthcare seeking practices through thematic qualitative analysis.{R}esults: {A}mong the 245 women surveyed, 13.9/100 did not attend any {ANC} visits. {S}chool level, occupation and gravidity positively infuenced the likelihood of attending one or more {ANC} visits. {T}he additional use of traditional caregivers remained predominant and was perceived as potentially complementary to medical care. {N}ine in ten (91/100) women expressed a preference for delivery at healthcare facilities ({HF}s), but 61/100 of births were assisted by a skilled birth attendant ({SBA}).{T}he school level; the frequency of {ANC}s; the origin region; and the preference between modern or traditional care infuenced the use of {SBA}s at delivery. {A} lack of preparation (fnancial and logistics problems) and women's low involvement in decision making at delivery were the main barriers to giving birth at {HF}s. {C}onclusion: {T}he use of maternal healthcare services is starting to gain ground, although many women and their relatives still use traditional caregivers at the same time. {R}elatives play a crucial role in maternal healthcare seeking. {I}t  would be necessary to target women's relatives for awareness-raising messages about {ANC} and childbirth in healthcare facilities and to support and formalize collaborations between traditional healers and biomedical caregivers.},
  keywords = {{MADAGASCAR} ; {ANTANANARIVO} ; {VAKINANKARATRA} {REGION} ; {MORAMANGA} {REGION}},
  booktitle = {},
  journal = {{BMC} {P}regnancy and {C}hildbirth},
  volume = {21},
  numero = {},
  pages = {428 [13 ]},
  ISSN = {1471-2393},
  year = {2021},
  DOI = {10.1186/s12884-021-03930-2},
  URL = {https://www.documentation.ird.fr/hor/fdi:010082430},
}