TY - JOUR
T1 - PregnantWomen's Intentions and subsequent behaviors regarding maternal and neonatal service utilization
T2 - Results from a cohort study in nyanza province, Kenya
AU - Creanga, Andreea A.
AU - Odhiambo, George Awino
AU - Odera, Benjamin
AU - Odhiambo, Frank O.
AU - Desai, Meghna
AU - Goodwin, Mary
AU - Laserson, Kayla
AU - Goldberg, Howard
PY - 2016/9
Y1 - 2016/9
N2 - Higher use of maternal and neonatal health (MNH) services may reduce maternal and neonatal mortality in Kenya. This study aims to: 1) prospectively explore women's intentions to use MNH services (antenatal care, delivery in a facility, postnatal care, neonatal care) at <20 and 30-35 weeks' gestation and their actual use of these services; 2) identify predictors of intention-behavior discordance among women with positive service use intentions; 3) examine associations between place of delivery, women's reasons for choosing it, and birthing experiences.We used data from a 2012-2013 population-based cohort of pregnant women in the Demographic Surveillance Site in Nyanza province, Kenya. Of 1,056 women completing the study (89.1% response rate), 948 had live-births and 22 stillbirths, and they represent our analytic sample. Logistic regression analysis identified predictors of intentionbehavior discordance regarding delivery in a facility and use of postnatal and neonatal care. At <20 and 30-35 weeks' gestation, most women intended to seek MNH services (93.9% and 87.5%, respectively, for all services assessed). Actual service use was high for antenatal (98.1%) and neonatal (88.5%) care, but lower for delivery in a facility (76.9%) and postnatal care (51.8%).Woman's age >35 and high-school education were significant predictors of intention-behavior discordance regarding delivery in a facility; several deliveryrelated factors were significantly associated with intention-behavior discordance regarding use of postnatal and neonatal care. Delivery facilities were chosen based on proximity to women's residence, affordability, and service quality; among women who delivered outsidea health facility, 16.3% could not afford going to a facility. Good/very good birth experiences were reportedby 93.6% of women who delivered in a facility and 32.6% of women who did not.We found higher MNH service utilization than previously documented in Nyanza province. Further increasing the number of facility deliveries and use of postnatal care may improve MNH in Kenya.
AB - Higher use of maternal and neonatal health (MNH) services may reduce maternal and neonatal mortality in Kenya. This study aims to: 1) prospectively explore women's intentions to use MNH services (antenatal care, delivery in a facility, postnatal care, neonatal care) at <20 and 30-35 weeks' gestation and their actual use of these services; 2) identify predictors of intention-behavior discordance among women with positive service use intentions; 3) examine associations between place of delivery, women's reasons for choosing it, and birthing experiences.We used data from a 2012-2013 population-based cohort of pregnant women in the Demographic Surveillance Site in Nyanza province, Kenya. Of 1,056 women completing the study (89.1% response rate), 948 had live-births and 22 stillbirths, and they represent our analytic sample. Logistic regression analysis identified predictors of intentionbehavior discordance regarding delivery in a facility and use of postnatal and neonatal care. At <20 and 30-35 weeks' gestation, most women intended to seek MNH services (93.9% and 87.5%, respectively, for all services assessed). Actual service use was high for antenatal (98.1%) and neonatal (88.5%) care, but lower for delivery in a facility (76.9%) and postnatal care (51.8%).Woman's age >35 and high-school education were significant predictors of intention-behavior discordance regarding delivery in a facility; several deliveryrelated factors were significantly associated with intention-behavior discordance regarding use of postnatal and neonatal care. Delivery facilities were chosen based on proximity to women's residence, affordability, and service quality; among women who delivered outsidea health facility, 16.3% could not afford going to a facility. Good/very good birth experiences were reportedby 93.6% of women who delivered in a facility and 32.6% of women who did not.We found higher MNH service utilization than previously documented in Nyanza province. Further increasing the number of facility deliveries and use of postnatal care may improve MNH in Kenya.
UR - http://www.scopus.com/inward/record.url?scp=84991615272&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84991615272&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0162017
DO - 10.1371/journal.pone.0162017
M3 - Article
C2 - 27622496
AN - SCOPUS:84991615272
SN - 1932-6203
VL - 11
JO - PloS one
JF - PloS one
IS - 9
M1 - e0162017
ER -