title: Utilisation of maternal health services by adolescent mothers in Kenya: analysis of the demographic health survey 2008-2009.
abstract: BACKGROUND
  Many Kenyan adolescents die following pregnancy and childbirth complications. Maternal health services (MHS) utilisation is key to averting such poor outcomes. Our objectives were to understand the characteristics of adolescent mothers in Kenya, describe their MHS utilisation pattern and explore factors that influence this pattern.
  
  
  METHODS
  We collected demographic and MHS utilisation data of all 301 adolescent mothers aged 15-19 years included in the Kenya Demographic Health Survey 2008/2009 (KDHS). Descriptive statistics were used to characterise them and their MHS utilisation patterns. Bivariate and multivariate analyses were used to test associations between selected predictor variables and MHS utilisation.
  
  
  RESULTS
  Eighty-six percent, 48% and 86% of adolescent mothers used ante-natal care (ANC), skilled birth attendance (SBA) and post-natal care (PNC), respectively. Adolescent mothers from the richest quintile were nine (CI=2.00-81.24, p=0.001) and seven (CI=3.22-16.22, p<0.001) times more likely to use ANC and SBA, respectively, compared to those from the poorest. Those with primary education were four (CI=1.68-9.64, p<0.001) and two (CI=0.97-4.81, p=0.043) times more likely to receive ANC and SBA, respectively, compared to uneducated mothers, with similar significant findings amongst their partners. Urban adolescent mothers were six (CI=1.89-32.45, p=0.001) and four (CI=2.00-6.20, p<0.001) times more likely to use ANC and SBA, respectively, compared to their rural counterparts. The odds of Maasai adolescent mothers using ANC was 90% (CI=0.02-0.93, p=0.010) lower than that of Kalenjin mothers.
  
  
  CONCLUSIONS
  Adolescent MHS utilisation in Kenya is an inequality issue. To address this, focus should be on the poorest, least educated, rural-dwelling adolescent mothers living in the most disadvantaged communities.
authors.affiliation: Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom of Great Britain and Northern Ireland.|Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, United States of America.
authors.forename: Oluwasola
authors.initials: O
authors.lastname: Banke-Thomas
authors.affiliation: Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom of Great Britain and Northern Ireland.|McCain Institute for International Leadership, Arizona State University, Tempe, Arizona, United States of America.
authors.forename: Aduragbemi
authors.initials: A
authors.lastname: Banke-Thomas
authors.affiliation: Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom of Great Britain and Northern Ireland.
authors.forename: Charles Anawo
authors.initials: CA
authors.lastname: Ameh
keywords: Kenya; adolescent health; adolescents; ante-natal care (ANC); delivery; maternal health; maternal health services (MHS); post-natal care (PNC); utilisation of health services