[Prenatal care in the city of Marrakech]

The data reported here come from a survey conducted in 2008, in direct interviews, according to a standard questionnaire, of 1712 women visiting 15 health centers in Marrakech. We selected 1202 women who gave birth during the past five years to examine the impact of socioeconomic and biodemographic determinants on access to prenatal care in this city. We also identified 309 women in our sample who were pregnant during the survey and studied the quality and content of their prenatal care. Around 90% of pregnant women consulted at least once during pregnancy. These results indicate that women in Marrakesh use prenatal care at higher rates than the national and regional population. This is likely to be explained by the large number of public health centers relatively well distributed throughout the city of Marrakech, although periurban areas are much less well endowed. Our analysis nonetheless indicates that 10% of the women in Marrakech do not consult at any time during pregnancy, although free care is provided in public health centers and outreach programs of the Department of Health encourage women to be monitored. Multiple sociocultural, socioeconomic, and biodemographic factors promote recourse to prenatal care. The most vulnerable pregnant women, that is, multiparous women living in periurban areas, the less educated women, and women of rural origin, are also those the least monitored. Most of the obstacles raised by the interviewees are maternal barriers, that is, related to the women themselves. These include indifference, recklessness, and ignorance of the risks: these barriers are related to maternal illiteracy and to a failure to understand the importance of medical surveillance.