Factors associated with utilization of sulphadoxine-pyrimethamine during pregnancy among women in Kenya: a cross-sectional study

The effectiveness of sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment during pregnancy for malaria is well established. However, adherence to recommended guidelines remains poor. This study examines factors related to receipt of SP among pregnant women in Kenya. Descriptive and inferential statistics for complex survey data were utilized using the 2008-2009 Kenya Demographic and Health Survey. With the exception of women residing in Nyanza, women who reside in other provinces were more likely to receive one dose of SP versus none compared to women living in Nairobi. Women receiving antenatal care from a nurse or midwife and women who owned a bed net were almost twice as likely to receive one dose of SP versus none (aOR 1.92, 95% CI 1.28, 2.86 and aOR 1.79; 95% CI 1.12, 2.78; respectively); whereas, women who received other anti-malarial drugs were over 90% less likely to receive one dose of SP versus none (aOR 0.08; 95% CI 0.02, 0.26). Among women who receive any SP, increased numbers of antenatal care visits were associated with receipt of two or more doses of SP (aOR 1.16; 95% CI 1.02, 1.32-per additional visit), while women living in the western province were nearly 75% less likely to receive two or more doses compared to women in Nairobi (aOR 0.27; 95% CI 0.08, 0.94). Receipt of the recommended ≥2 doses of SP is associated with predisposing and enabling characteristics. Further research is needed to identify barriers to receiving SP during pregnancy.