Determinants of use of intermittent preventive treatment for malaria during pregnancy in Kenya: A cross-sectional study based on the 2015 Malaria Indicator Survey

Abstract: Background: Malaria in pregnancy is a preventable public health concern causing adverse maternal and fetal outcomes. Intermittent Preventive Treatment during pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) is one of the main strategies used to prevent malaria. In 2013, Kenya adopted the World Health Organization (WHO) recommendations of using three or more doses of IPTp-SP. A Recent study done in Kenya reported low (25%) uptake. The aim of this study was to investigate determinants of use of IPTp-SP in Kenya. Methods: Data was drawn from the 2015 Kenya Malaria Indicator Survey. A total of 1839 women aged 15–49 years old, with pregnancies up to 3 years prior to the survey were analyzed. Bivariate and multivariate logistic regression analysis used to assess for independent predictors of IPTp-SP use. Results: Overall 57.3% of respondents used at least one dose (IPTp1) and 27.7% used three or more doses (IPTp3) which were both below roll back malaria targets (80%). Majority (94.4%) attended antenatal care. Number of visits at antenatal care, treated bed nets utilization and residing in Coastal, Nyanza and Western region increased the odds of IPTp1 and IPTp3. Low malaria knowledge, residing in Central and North eastern region lowered odds IPTp1 and IPTp3. Higher education decreased the odds of IPTp1 but not IPTp3. Conclusion: Due to the low IPTp-SP use, despite a high antenatal care attendance, there is need to ensure SP availability at antenatal care. Continuous educational training for all health care providers and increasing messages on malaria prevention via posters and media recommended.