Reproductive health issues in rural Western Kenya

Anna M van Eijk¹^,4 , Kim A Lindblade² , Frank Odhiambo³ , Elizabeth Peterson⁴ , Evallyne Sikuku³ , John G Ayisi³ , Peter Ouma³ , Daniel H Rosen⁵ and Laurence Slutsker²

¹Department of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, University of Amsterdam, The Netherlands

²Division of Parasitic Diseases, National Centre for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta GA, USA

³Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578, Kisumu, Kenya

⁴Vermont Department of Health, Burlington, VT, USA

⁵Global Aids Program, Centers for Disease Control and Prevention, Zimbabwe

author email corresponding author email

Reproductive Health 2008, 5:1doi:10.1186/1742-4755-5-1


Published:	18 March 2008

Abstract

Background

We describe reproductive health issues among pregnant women in a rural area of Kenya with a high coverage of insecticide treated nets (ITNs) and high prevalence of HIV (15%).

Methods

We conducted a community-based cross-sectional survey among rural pregnant women in western Kenya. A medical, obstetric and reproductive history was obtained. Blood was obtained for a malaria smear and haemoglobin level, and stool was examined for geohelminths. Height and weight were measured.

Results

Of 673 participants, 87% were multigravidae and 50% were in their third trimester; 41% had started antenatal clinic visits at the time of interview and 69% reported ITN-use. Malaria parasitemia and anaemia (haemoglobin < 11 g/dl) were detected among 36% and 53% of the women, respectively. Geohelminth infections were detected among 76% of the 390 women who gave a stool sample. Twenty percent of women were underweight, and sixteen percent reported symptoms of herpes zoster or oral thrush in the last two months. Nineteen percent of all women reported using a contraceptive method to delay or prevent pregnancy before the current pregnancy (injection 10%, pill 8%, condom 0.4%). Twenty-three percent of multigravidae conceived their current pregnancy within a year of the previous pregnancy. More than half of the multigravidae (55%) had ever lost a live born child and 21% had lost their last singleton live born child at the time of interview.

Conclusion

In this rural area with a high HIV prevalence, the reported use of condoms before pregnancy was extremely low. Pregnancy health was not optimal with a high prevalence of malaria, geohelminth infections, anaemia and underweight. Chances of losing a child after birth were high. Multiple interventions are needed to improve reproductive health in this area.