Skip to main content

Advertisement

SpringerLink
Log in

Factors Associated with Utilization of Sulphadoxine–Pyrimethamine During Pregnancy Among Women in Kenya: A Cross-Sectional Study

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

The effectiveness of sulphadoxine–pyrimethamine (SP) for intermittent preventive treatment during pregnancy for malaria is well established. However, adherence to recommended guidelines remains poor. This study examines factors related to receipt of SP among pregnant women in Kenya. Descriptive and inferential statistics for complex survey data were utilized using the 2008–2009 Kenya Demographic and Health Survey. With the exception of women residing in Nyanza, women who reside in other provinces were more likely to receive one dose of SP versus none compared to women living in Nairobi. Women receiving antenatal care from a nurse or midwife and women who owned a bed net were almost twice as likely to receive one dose of SP versus none (aOR 1.92, 95 % CI 1.28, 2.86 and aOR 1.79; 95 % CI 1.12, 2.78; respectively); whereas, women who received other anti-malarial drugs were over 90 % less likely to receive one dose of SP versus none (aOR 0.08; 95 % CI 0.02, 0.26). Among women who receive any SP, increased numbers of antenatal care visits were associated with receipt of two or more doses of SP (aOR 1.16; 95 % CI 1.02, 1.32—per additional visit), while women living in the western province were nearly 75 % less likely to receive two or more doses compared to women in Nairobi (aOR 0.27; 95 % CI 0.08, 0.94). Receipt of the recommended ≥2 doses of SP is associated with predisposing and enabling characteristics. Further research is needed to identify barriers to receiving SP during pregnancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ministry of Public Health and Sanitation, Kenya National Bureau of Statistics & ICF Macro. (2009). 2007 Kenya Malaria Indicator Survey. Nairobi: Ministry of Public Health and Sanitation Division of Malaria Control.

    Google Scholar 

  2. Roll Back Malaria Partnership.(2005). Roll back malaria global strategic plan 2005–2015. http://www.rbm.who.int/forumV/docs/gsp_en.pdf. [Date of Access 21 Nov 2011].

  3. United States Agency for International Development-Kenya. Malaria. (2011). http://kenya.usaid.gov/programs/health/72.[Date of Access 2 Feb 2012].

  4. Vallely, A., Vallely, L., Changalucha, J., et al. (2007). Intermittent preventive treatment for malaria in pregnancy in Africa: What’s new, what’s needed? Malaria Journal, 6, 16. doi:10.1186/1475-2875-6-16.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Lagerberg, R. E. (2008). Malaria in pregnancy: A literature review. Journal of Midwifery and Womens Health, 53(3), 209–215.

    Article  Google Scholar 

  6. Ministry of Public Health and Sanitation, Kenya National Bureau of Statistics & ICF Macro. (2011). 2010 Kenya Malaria Indicator Survey. Nairobi: Ministry of Public Health and Sanitation Division of Malaria Control.

    Google Scholar 

  7. Ojakaa, D., Yamo, E., Collymore, Y., et al. (2011). Perceptions of malaria and vaccines in Kenya. Human Vaccines, 7(10), 1096–1099.

    Article  PubMed  Google Scholar 

  8. Ramharter, M., Schuster, K., Bouyou-Akotet, M. K., et al. (2007). Malaria in pregnancy before and after the implementation of a national IPTp program in Gabon. American Journal of Tropical Medicine and Hygiene, 77(3), 418–422.

    PubMed  Google Scholar 

  9. van Eijk, A. M., Ayisi, J. G., ter Kuile, F. O., et al. (2004). Implementation of intermittent preventive treatment with sulphadoxine–pyrimethamine for control of malaria in pregnancy in Kisumu, western Kenya. Tropical Medicine and International Health, 9(5), 630–637.

    Article  PubMed  Google Scholar 

  10. Shulman, C. E., Dorman, E. K., Cutts, F., et al. (1999). Intermittent sulphadoxine–pyrimethamine to prevent severe anaemia secondary to malaria in pregnancy: a randomised placebo-controlled trial. Lancet, 353(9153), 632–636.

    Article  CAS  PubMed  Google Scholar 

  11. van Eijk, A. M., Blokland, I. E., Slutsker, L., et al. (2005). Use of intermittent preventive treatment for malaria in pregnancy in a rural area of western Kenya with high coverage of insecticide-treated bed nets. Tropical Medicine and International Health, 10(11), 1134–1140.

    Article  PubMed  Google Scholar 

  12. World Health Organization. (2012). Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP):Updated WHO Policy Recommendation. http://www.who.int/malaria/iptp_sp_updated_policy_recommendation_en_102012.pdf. [Date of Access 22 Mar 2013].

  13. Ministry of Health. (2010). National guidelines for diagnosis, treatment and prevention of malaria for health workers (3rd ed.). Nairobi: Ministry of Health.

    Google Scholar 

  14. Ouma, P. O., van Eijk, A. M., Hamel, M. J., et al. (2007). The effect of health care worker training on the use of intermittent preventive treatment for malaria in pregnancy in rural western Kenya. Tropical Medicine and International Health, 12(8), 953–961.

    Article  CAS  PubMed  Google Scholar 

  15. Andersen, R., & Newman, J. F. (1973). Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly: Health and Society, 51(1), 95–124.

    Article  CAS  Google Scholar 

  16. Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36(1), 1–10.

    Article  CAS  PubMed  Google Scholar 

  17. Beeckman, K., Louckx, F., & Putman, K. (2011). Predisposing, enabling and pregnancy-related determinants of late initiation of prenatal care. Maternal and Child Health Journal, 15(7), 1067–1075.

    Article  PubMed  Google Scholar 

  18. Johnson, A. A., Hatcher, B. J., El-Khorazaty, M. N., et al. (2007). Determinants of inadequate prenatal care utilization by African American women. Journal of Health Care for the Poor and Underserved, 18(3), 620–636.

    Article  PubMed  Google Scholar 

  19. Corsi, D. J., Neuman, M., Finlay, J. E., et al. (2012). Demographic and health surveys: A profile. International Journal of Epidemiology, 41(6), 1602–1613.

    Article  PubMed  Google Scholar 

  20. Pullum, T.W. (2008). An assessment of the quality of data on health and nutrition in the DHS surveys, 1993–2003. Methodological Reports No. 6. Calverton, MD: Macro International Inc.

  21. Vaessen, M. (1996). The potential of the demographic and health surveys (DHS) for the evaluation and monitoring of maternal and child health indicators. In M. Khlat (Ed.), Demographic evaluation of health programmes (proceedings). Paris: CICRED/UNFPA.

    Google Scholar 

  22. Wirth, M.,Wirth, E., Delamonica, E., et al. (2006). Monitoring health equity in the MDGs: A practical guide. Center for International Earth Science Information Network.

  23. Kenya National Bureau of Statistics & ICF Macro. (2010). Kenya demographic and health survey 2008–2009. Maryland: Calverton.

    Google Scholar 

  24. Noor, A. M., Gething, P. W., Alegana, V. A., et al. (2009). The risks of malaria infection in Kenya in 2009. BMC Infectious Diseases, 9, 180. doi:10.1186/1471-2334-9-180.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Okara, R. M., Sinka, M. E., Minakawa, N., et al. (2010). Distribution of the main malaria vectors in Kenya. Malaria Journal, 9, 69. doi:10.1186/1475-2875-9-69.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Sande, J. H., Kaseje, D., Nyapada, L., et al. (2010). Fear of being tested for HIV at ANC clinics associated with low uptake of intermittent preventive treatment (IPT) of malaria among pregnant women attending Bondo District Hospital, Western Kenya. East African Journal of Public Health, 7(1), 92–96.

    PubMed  Google Scholar 

  27. Ye, Y., Madise, N., Ndugwa, R., et al. (2009). Fever treatment in the absence of malaria transmission in an urban informal settlement in Nairobi, Kenya. Malaria Journal, 8, 160. doi:10.1186/1475-2875-8-160.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Gikandi, P. W., Noor, A. M., Gitonga, C. W., et al. (2008). Access and barriers to measures targeted to prevent malaria in pregnancy in rural Kenya. Tropical Medicine and International Health, 13(2), 208–217.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Kruk, M. E., Prescott, M. R., De, P. H., et al. (2009). Are doctors and nurses associated with coverage of essential health services in developing countries? A cross-sectional study. Human Resources for Health, 7, 27. doi:10.1186/1478-4491-7-27.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Ratcliffe, J., Ryan, M., & Tucker, J. (1996). The costs of alternative types of routine antenatal care for low-risk women: Shared care vs care by general practitioners and community midwives. Journal of Health Services Research and Policy, 1(3), 135–140.

    CAS  PubMed  Google Scholar 

  31. Rowley, M. J., Hensley, M. J., Brinsmead, M. W., et al. (1995). Continuity of care by a midwife team versus routine care during pregnancy and birth—A randomized trial. Medical Journal of Australia, 163(6), 289–293.

    CAS  PubMed  Google Scholar 

  32. Turnbull, D., Young, D., Shields, N., et al. (1997). A new style of midwife-managed antenatal care: Costs and satisfaction. British Journal of Midwifery, 5(9), 540–545.

    Article  Google Scholar 

  33. Chuma, J., Okungu, V., & Molyneux, C. (2010). Barriers to prompt and effective malaria treatment among the poorest population in Kenya. Malaria Journal, 9, 144. doi:10.1186/1475-2875-9-144.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Holtz, T. H., Kachur, S. P., Roberts, J. M., et al. (2004). Use of antenatal care services and intermittent preventive treatment for malaria among pregnant women in Blantyre District. Malawi. Tropical Medicine and International Health, 9(1), 77–82.

    Article  Google Scholar 

  35. Launiala, A., & Honkasalo, M. L. (2007). Ethnographic study of factors influencing compliance to intermittent preventive treatment of malaria during pregnancy among Yao women in rural Malawi. Transactions of the Royal Society of Tropical Medicine and Hygiene, 101(10), 980–989.

    Article  PubMed  Google Scholar 

  36. Akinleye, S. O., Falade, C. O., & Ajayi, I. O. (2009). Knowledge and utilization of intermittent preventive treatment for malaria among pregnant women attending antenatal clinics in primary health care centers in rural southwest, Nigeria: A cross-sectional study. Bmc Pregnancy and Childbirth, 9, 28. doi:10.1186/1471-2393-9-28.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Pell, C., Straus, L., Andrew, E. V., et al. (2011). Social and cultural factors affecting uptake of interventions for malaria in pregnancy in Africa: A systematic review of the qualitative research. PLoS One, 6(7), e22452. doi:10.1371/journal.pone.0022452.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  38. Audo, M. O., Ferguson, A., & Njoroge, P. K. (2005). Quality of health care and its effects in the utilisation of maternal and child health services in Kenya. East African Medical Journal, 82(11), 547–553.

    CAS  PubMed  Google Scholar 

  39. Mwaniki, P. K., Kabiru, E. W., & Mbugua, G. G. (2002). Utilisation of antenatal and maternity services by mothers seeking child welfare services in Mbeere District, Eastern Province, Kenya. East African Medical Journal, 79(4), 184–187.

    Article  CAS  PubMed  Google Scholar 

  40. Guyatt, H. L., Noor, A. M., Ochola, S. A., et al. (2004). Use of intermittent presumptive treatment and insecticide treated bed nets by pregnant women in four Kenyan districts. Tropical Medicine and International Health, 9(2), 255–261.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank ICF International for providing access to the 2008–2009 Kenya Demographic and Health Survey.

Conflict of interest

The authors have no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Epidemiology, West Virginia University School of Public Health, Robert C. Byrd Health Sciences Center, 1 Medical Center Drive, PO Box 9190, Morgantown, WV, 26505-9190, USA

    Zelalem T. Haile & Kelly K. Gurka

  2. School of Nursing, West Virginia University, Robert C. Byrd Health Sciences Center, 1 Medical Center Drive, PO Box 9630, Morgantown, WV, 26506, USA

    Ilana R. Azulay Chertok

  3. Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Robert C. Byrd Health Sciences Center, 1 Medical Center Drive, PO Box 9500, Morgantown, WV, 26506-9500, USA

    Usha Sambamoorthi

Authors
  1. Zelalem T. Haile
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kelly K. Gurka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ilana R. Azulay Chertok
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Usha Sambamoorthi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zelalem T. Haile.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Haile, Z.T., Gurka, K.K., Chertok, I.R.A. et al. Factors Associated with Utilization of Sulphadoxine–Pyrimethamine During Pregnancy Among Women in Kenya: A Cross-Sectional Study. Matern Child Health J 18, 1104–1113 (2014). https://doi.org/10.1007/s10995-013-1340-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-013-1340-8

Keywords

Search

Navigation