Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
BMC Pregnancy Childbirth. 2013 Jul 11;13:146. doi: 10.1186/1471-2393-13-146.
Antenatal care (ANC) is a key strategy to decreasing maternal mortality in low-resource settings. ANC clinics provide resources to improve nutrition and health knowledge and promote preventive health practices. We sought to compare the knowledge, attitude and practices (KAP) among women seeking and not-seeking ANC in rural Kenya.
Data from a community-based cross-sectional survey conducted in Western Province, Kenya were used. Nutrition knowledge (NKS), health knowledge (HKS), attitude score (AS), and dietary diversity score (DDS) were constructed indices. χ2 test and Student's t-test were used to compare proportions and means, respectively, to assess the difference in KAP among pregnant women attending and not-attending ANC clinics. Multiple regression analyses were used to assess the impact of the number of ANC visits (none, <4, ≥4) on knowledge and practice scores, adjusting for maternal socio-demographic confounders, such as age, gestational age, education level and household wealth index.
Among the 979 pregnant women in the survey, 59% had attended ANC clinics while 39% had not. The mean (±SD) NKS was 4.6 (1.9) out of 11, HKS was 6.2 (1.7) out of 12, DDS was 4.9 (1.4) out of 12, and AS was 7.4 (2.2) out of 10. Nutrition knowledge, attitudes, and DDS were not significantly different between ANC clinic attending and non-attending women. Among women who attended ANC clinics, 82.6% received malaria and/or antihelmintic treatment, compared to 29.6% of ANC clinic non-attendees. Higher number of ANC clinic visits and higher maternal education level were significantly positively associated with maternal health knowledge.
Substantial opportunities exist for antenatal KAP improvement among women in Western Kenya, some of which could occur with greater ANC attendance. Further research is needed to understand multi-level factors that may affect maternal knowledge and practices.
产前护理（ANC）是降低资源匮乏环境下孕产妇死亡率的关键策略。ANC 诊所提供资源以改善营养和健康知识，并促进预防保健实践。我们试图比较在肯尼亚西部农村寻求和不寻求 ANC 的妇女的知识、态度和实践（KAP）。
使用肯尼亚西部省进行的基于社区的横断面调查的数据。构建了营养知识（NKS）、健康知识（HKS）、态度得分（AS）和饮食多样性得分（DDS）的指标。使用卡方检验和学生 t 检验分别比较比例和平均值，以评估在接受和不接受 ANC 诊所的孕妇之间 KAP 的差异。使用多元回归分析来评估 ANC 就诊次数（无、<4、≥4）对知识和实践得分的影响，同时调整孕产妇社会人口统计学混杂因素，如年龄、孕龄、教育水平和家庭财富指数。
在调查的 979 名孕妇中，59%的孕妇曾到 ANC 诊所就诊，39%的孕妇未到 ANC 诊所就诊。NKS 的平均（±SD）为 11 分中的 4.6（1.9）分，HKS 为 12 分中的 6.2（1.7）分，DDS 为 12 分中的 4.9（1.4）分，AS 为 10 分中的 7.4（2.2）分。ANC 诊所就诊和未就诊的孕妇之间，营养知识、态度和 DDS 没有显著差异。在接受 ANC 诊所服务的妇女中，82.6%接受了疟疾和/或驱虫治疗，而 ANC 诊所未就诊的妇女中只有 29.6%接受了治疗。ANC 诊所就诊次数和产妇教育程度较高与产妇健康知识显著正相关。
在肯尼亚西部，妇女的 ANC KAP 有很大的改进空间，其中一些可以通过增加 ANC 就诊次数来实现。需要进一步研究了解可能影响产妇知识和实践的多层次因素。
