Health provider and trial staff characteristics.

<p>Health provider and trial staff characteristics.</p

Analysis framework for focus group discussions with trial participants.

<p>Analysis framework for focus group discussions with trial participants.</p

Characteristics of trial participants in the focus group discussions.

<p>Characteristics of trial participants in the focus group discussions.</p

Selection of trial staff and health providers for the in-depth interviews.

<p>Selection of trial staff and health providers for the in-depth interviews.</p

Analysis framework for in-depth interviews with health providers and trial staff.

<p>Analysis framework for in-depth interviews with health providers and trial staff.</p

Experiences and perceptions on the acceptability of IPTp-DP or IST-DP vs IPTp-SP among trial participants, trial staff and health providers.

<p>Experiences and perceptions on the acceptability of IPTp-DP or IST-DP vs IPTp-SP among trial participants, trial staff and health providers.</p

Pregnant Women’s Intentions and Subsequent Behaviors Regarding Maternal and Neonatal Service Utilization: Results from a Cohort Study in Nyanza Province, Kenya

<div><p>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 intention-behavior 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 delivery-related 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 outside a health facility, 16.3% could not afford going to a facility. Good/very good birth experiences were reported by 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.</p></div

Intentions, behaviors and intentions to repeat behaviors regarding use of maternal and neonatal health services.

<p><i>Notes</i>: ANC, antenatal care; PNC, postnatal care; *of those with a live birth.</p

Predictors of discordance between women’s intentions and behaviors regarding postnatal care: Kenya, 2013.

<p>Predictors of discordance between women’s intentions and behaviors regarding postnatal care: Kenya, 2013.</p

MOESM1 of Effectiveness of the delivery of interventions to prevent malaria in pregnancy in Kenya

Additional file 1: Table S1. Health facility performance for the delivery of IPTp with and without directly observed therapy (DOT) through the antenatal care platform. Table S2. Health facility performance for the delivery of ITN through the antenatal care platform at the time of the first visit