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Citation Information

Type Journal Article - The American Journal of Tropical Medicine and Hygiene
Title Impact of the Integration of Water Treatment, Hygiene, Nutrition, and Clean Delivery Interventions on Maternal Health Service Use
Volume 96
Issue 5
Publication (Day/Month/Year) 2017
Page numbers 1253-1260
URL https://www.ncbi.nlm.nih.gov/pubmed/28193744
Reducing barriers associated with maternal health service use, household water treatment, and improved hygiene is
important for maternal and neonatal health outcomes. We surveyed a sample of 201 pregnant women who
participated in a clinic-based intervention in Kenya to increase maternal health service use and improve household
hygiene and nutrition through the distribution of water treatment products, soap, protein-fortified flour, and clean
delivery kits. From multivariable logistic regression analyses, the adjusted odds of  4 antenatal care (ANC4+) visits
(odds ratio [OR] = 3.0, 95% confidence interval [CI] = 1.9–4.5), health facility delivery (OR = 5.3, 95% CI = 3.4–
8.3), and any postnatal care visit (OR = 2.8, 95% CI = 1.9–4.2) were higher at follow-up than at baseline, adjusting
for demographic factors. Women who completed primary school had higher odds of ANC4+ visits (OR = 1.8, 95%
CI = 1.1–2.9) and health facility delivery (OR = 4.2, 95% CI = 2.5–7.1) than women with less education. For
women who lived  2.5 km from the health facility, the estimated odds of health facility delivery (OR = 2.4, 95% CI
= 1.5–4.1) and postnatal care visit (OR = 1.6, 95% CI = 1.0–2.6) were higher than for those who lived > 2.5 km
away. Compared with baseline, a higher percentage of survey participants at follow-up were able to demonstrate
proper handwashing (P = 0.001); water treatment behavior did not change. This evaluation suggested that hygiene,
nutritional, clean delivery incentives, higher education level, and geographical contiguity to health facility were
associated with increased use of maternal health services by pregnant women.

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