Knowledge, attitude and practice of COVID-19 preventive measures among pregnant women in antenatal clinics in western Kenya

Introduction: Coronavirus disease 2019 (COVID-19) infection among pregnant women can lead to an increased risk of adverse pregnancy outcomes. Preventive measures are essential as there is no definite cure. This study determined the knowledge, attitude and practice of COVID-19 preventive measures including COVID-19 vaccine uptake, among pregnant women attending antenatal clinics in western Kenya. Methodology: A mixed-methods study was conducted during the fourth wave of COVID-19 in Kisumu and Siaya counties in Kenya from December 2021 to January 2022. Fishers’ Exact/Chi-square tests were used to determine the association between variables, and multinomial logistics regression were used to identify the predictors of knowledge, attitude and practice. Thematic analyses were used to describe qualitative findings. Results: Of the 385 women interviewed, 99.7% and 100%, had good and above knowledge and attitude respectively, while 23%, had adequate practices. COVID-19 vaccine uptake was 28%. Respondents from households with 3-5 and 6-8 members were 2.11 and 2.58 times more likely to have poor practices, whereas respondents with tertiary level of education were 0.48 times less likely to have poor practices. Focus group discussions revealed that poor COVID-19 vaccine uptake was caused by vaccine myths and misconceptions, whereas the cost of masks, the smell of soaps and sanitizers and inadequate space in the clinics and workplaces were identified as barriers to COVID-19 prevention practices. Conclusions: Although knowledge and attitude scores towards COVID-19 preventive measures were high, this did not reflect in pregnant women engaging in adequate preventive practices and vaccine uptake.