Population Council, Kenya, Avenue 5, 3rd Floor, Rose Avenue, P.O Box 17643-00500, Nairobi, Kenya.
Kisumu Medical and Education Trust (KMET), P. O Box 6805-40103, Kisumu, Kenya.
Malar J. 2023 Aug 23;22(1):241. doi: 10.1186/s12936-023-04679-z.
Malaria in pregnancy remains a major public health problem in endemic areas of the sub-Saharan African (SSA) region. However, there is limited understanding of the association between women's empowerment and the uptake of sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria during pregnancy (IPTp-SP) in Kenya. This study examines the association between women's empowerment indicators (decision-making power, control of assets, education, and employment status) and the uptake of three or more doses of IPTp-SP in the Lake endemic region of Kenya.
The analysis utilized a dataset from a cross-sectional baseline survey of 3129 women aged 15-49 years in Kisumu and Migori Counties who had a live birth within the last 2 years preceding the study. Data were collected between June to August 2021. A descriptive analysis was conducted to show the distribution of respondents by key background characteristics, and bivariate and multivariate logistic regression to examine statistically significant associations between women's empowerment measures and the uptake of 3+ doses of IPTp-SP.
Among the 3129 women surveyed, 1978 (65.7%) received 3+ doses of IPTp-SP during their most recent pregnancy. Controlling for individual characteristics and the number of ANC visits, the odds of taking 3+ doses of IPTp-SP increased among women who had high decision-making autonomy (AOR = 2.33; CI = 1.81-3.01; P < 0.001); and tertiary level of educational attainment (AOR = 1.51; CI = 1.10-2.06). However, the association between control of assets and uptake of IPTp-SP was positive but not statistically significant.
Women's decision-making autonomy and educational attainment were positively associated with the uptake of IPTp-SP. As a result, maternal health interventions should focus on less empowered women, specifically those with less decision-making autonomy and no/low formal education, as they are less likely to achieve optimal uptake of IPTp-SP during pregnancy.
在撒哈拉以南非洲（SSA）地区的疟疾流行地区，妊娠疟疾仍然是一个重大的公共卫生问题。然而，对于妇女赋权与在肯尼亚接受磺胺多辛-乙胺嘧啶间歇性预防治疗（IPTp-SP）之间的关联，我们的了解有限。本研究调查了妇女赋权指标（决策权、资产控制权、教育程度和就业状况）与在肯尼亚湖泊流行地区接受三次或更多剂量的 IPTp-SP 之间的关联。
该分析利用了 2021 年 6 月至 8 月期间在基苏木和米戈里县进行的一项横断面基线调查的数据集，该调查涉及 3129 名年龄在 15-49 岁之间的妇女，她们在研究前的最近两年内有过活产。进行了描述性分析，以显示按关键背景特征分布的受访者分布情况，并进行了双变量和多变量逻辑回归分析，以检查妇女赋权措施与接受三次或更多剂量的 IPTp-SP 之间的统计学显著关联。
在接受调查的 3129 名妇女中，有 1978 名（65.7%）在最近一次妊娠中接受了三次或更多剂量的 IPTp-SP。在控制个人特征和 ANC 就诊次数后，具有高决策自主权的妇女接受三次或更多剂量的 IPTp-SP 的可能性增加（AOR=2.33；CI=1.81-3.01；P<0.001）；和三级教育程度（AOR=1.51；CI=1.10-2.06）。然而，资产控制权与 IPTp-SP 使用率之间的关联呈正相关，但无统计学意义。
妇女的决策自主权和教育程度与接受 IPTp-SP 呈正相关。因此，孕产妇保健干预措施应侧重于赋权较少的妇女，特别是那些决策权较小且没有/低正规教育的妇女，因为她们在妊娠期间不太可能实现最佳的 IPTp-SP 接受率。
