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A Safe Motherhood project in Kenya: assessment of antenatal attendance, service provision and implications for PMTCT

Wim Delva UGent, Elodie Yard, Stanley Lüchters UGent, Matthew Chersich UGent, Esther Muigai, Vicky Oyier and Marleen Temmerman UGent (2010) TROPICAL MEDICINE & INTERNATIONAL HEALTH. 15(5). p.584-591
abstract
Objectives : To investigate uptake and provision of antenatal care (ANC) services in the Uzazi Bora project: a demonstration-intervention project for Safe Motherhood and prevention of mother-to-child transmission of HIV in Kenya. Methods : Data were extracted from antenatal clinic, laboratory and maternity ward registers of all pregnant women attending ANC from January 2004 until September 2006 at three antenatal clinics in Mombasa and two in rural Kwale district of Coast Province, Kenya (n = 25 364). Multiple logistic and proportional odds logistic regression analyses assessed changes over time, and determinants of the frequency and timing of ANC visits, uptake of HIV testing, and provision of iron sulphate, folate and single-dose nevirapine (sd-NVP). Results : About half of women in rural and urban settings (52.2% and 49.2%, respectively) attended antenatal clinics only once. Lower parity, urban setting, older age and having received iron sulphate and folate supplements during the first ANC visit were independent predictors of more frequent visits. The first ANC visit occurred after 28 weeks of pregnancy for 30% (5894/19 432) of women. By mid-2006, provision of nevirapine to HIV-positive women had increased from 32.5% and 11.7% in rural and urban clinics, to 67.0% and 74.6%, respectively. Equally marked improvements were observed in the uptake of HIV testing and the provision of iron sulphate and folate. Conclusion : Provision of ANC services, including sd-NVP, increased markedly over time. While further improvements in quality are necessary, particular attention is needed to implement evidence-based interventions to alter ANC utilization patterns. Encouragingly, improved provision of basic essential obstetric care may increase attendance.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
SINGLE-DOSE NEVIRAPINE, CHILD HIV TRANSMISSION, MATERNAL HEALTH-CARE, SUB-SAHARAN AFRICA, PREVENTION, PROGRAM, HIV, Kenya, maternal health services, prenatal care, nevirapine, IMMUNODEFICIENCY-VIRUS TRANSMISSION, IMPLEMENTATION, COUNTRIES, PARTICIPATION
journal title
TROPICAL MEDICINE & INTERNATIONAL HEALTH
Trop. Med. Int. Health
volume
15
issue
5
pages
8 pages
Web of Science type
Article
Web of Science id
000276496100013
JCR category
TROPICAL MEDICINE
JCR impact factor
2.841 (2010)
JCR rank
3/19 (2010)
JCR quartile
1 (2010)
ISSN
1360-2276
DOI
10.1111/j.1365-3156.2010.02499.x
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
939640
handle
http://hdl.handle.net/1854/LU-939640
date created
2010-04-29 08:48:04
date last changed
2016-12-19 15:45:22
@article{939640,
  abstract     = {Objectives : To investigate uptake and provision of antenatal care (ANC) services in the Uzazi Bora project: a demonstration-intervention project for Safe Motherhood and prevention of mother-to-child transmission of HIV in Kenya.
Methods : Data were extracted from antenatal clinic, laboratory and maternity ward registers of all pregnant women attending ANC from January 2004 until September 2006 at three antenatal clinics in Mombasa and two in rural Kwale district of Coast Province, Kenya (n = 25 364). Multiple logistic and proportional odds logistic regression analyses assessed changes over time, and determinants of the frequency and timing of ANC visits, uptake of HIV testing, and provision of iron sulphate, folate and single-dose nevirapine (sd-NVP).
Results : About half of women in rural and urban settings (52.2\% and 49.2\%, respectively) attended antenatal clinics only once. Lower parity, urban setting, older age and having received iron sulphate and folate supplements during the first ANC visit were independent predictors of more frequent visits. The first ANC visit occurred after 28 weeks of pregnancy for 30\% (5894/19 432) of women. By mid-2006, provision of nevirapine to HIV-positive women had increased from 32.5\% and 11.7\% in rural and urban clinics, to 67.0\% and 74.6\%, respectively. Equally marked improvements were observed in the uptake of HIV testing and the provision of iron sulphate and folate.
Conclusion : Provision of ANC services, including sd-NVP, increased markedly over time. While further improvements in quality are necessary, particular attention is needed to implement evidence-based interventions to alter ANC utilization patterns. Encouragingly, improved provision of basic essential obstetric care may increase attendance.},
  author       = {Delva, Wim and Yard, Elodie and L{\"u}chters, Stanley and Chersich, Matthew and Muigai, Esther and Oyier, Vicky and Temmerman, Marleen},
  issn         = {1360-2276},
  journal      = {TROPICAL MEDICINE \& INTERNATIONAL HEALTH},
  keyword      = {SINGLE-DOSE NEVIRAPINE,CHILD HIV TRANSMISSION,MATERNAL HEALTH-CARE,SUB-SAHARAN AFRICA,PREVENTION,PROGRAM,HIV,Kenya,maternal health services,prenatal care,nevirapine,IMMUNODEFICIENCY-VIRUS TRANSMISSION,IMPLEMENTATION,COUNTRIES,PARTICIPATION},
  language     = {eng},
  number       = {5},
  pages        = {584--591},
  title        = {A Safe Motherhood project in Kenya: assessment of antenatal attendance, service provision and implications for PMTCT},
  url          = {http://dx.doi.org/10.1111/j.1365-3156.2010.02499.x},
  volume       = {15},
  year         = {2010},
}

Chicago
Delva, Wim, Elodie Yard, Stanley Lüchters, Matthew Chersich, Esther Muigai, Vicky Oyier, and Marleen Temmerman. 2010. “A Safe Motherhood Project in Kenya: Assessment of Antenatal Attendance, Service Provision and Implications for PMTCT.” Tropical Medicine & International Health 15 (5): 584–591.
APA
Delva, W., Yard, E., Lüchters, S., Chersich, M., Muigai, E., Oyier, V., & Temmerman, M. (2010). A Safe Motherhood project in Kenya: assessment of antenatal attendance, service provision and implications for PMTCT. TROPICAL MEDICINE & INTERNATIONAL HEALTH, 15(5), 584–591.
Vancouver
1.
Delva W, Yard E, Lüchters S, Chersich M, Muigai E, Oyier V, et al. A Safe Motherhood project in Kenya: assessment of antenatal attendance, service provision and implications for PMTCT. TROPICAL MEDICINE & INTERNATIONAL HEALTH. 2010;15(5):584–91.
MLA
Delva, Wim, Elodie Yard, Stanley Lüchters, et al. “A Safe Motherhood Project in Kenya: Assessment of Antenatal Attendance, Service Provision and Implications for PMTCT.” TROPICAL MEDICINE & INTERNATIONAL HEALTH 15.5 (2010): 584–591. Print.