Abstract
BackgroundUniversal access to and utilization of malaria prevention measures is defined as every person at malaria risk sleeping under a quality insecticide-treated mosquito net (ITN) and every pregnant woman at risk receiving at least two doses of sulfadoxine-pyrimethamine (SP). This study aimed to determine factors affecting accessibility, availability and utilisation of malaria interventions among women of reproductive age in Kilosa district in central Tanzania.MethodsWomen of reproductive age with children <5 years old or those who had been pregnant during the past 5 years were included in the study. A structured questionnaire was used to seek information on malaria knowledge, accessibility and utilization of malaria interventions during pregnancy.ResultsA total of 297 women (mean age=29±6.8 years) were involved. Seventy percent of the women had attained primary school education. About a quarter of women had two children of <5 years while over 58% had ≥3 children. Most (71.4%) women had medium general knowledge on malaria while only eight percent of them had good knowledge on malaria in pregnancy. A significant proportion of women were not aware of the reasons for taking SP during pregnancy (35%), timing for SP (18%), and the effect of malaria on pregnancy (45.8%). Timing for first dose of SP for intermittent preventive treatment in pregnancy (IPTp) was 1-3 months (28.4%) and 4-6 months (36.8%). Some 78.1% were provided with SP under supervision of the health provider. Knowledge on malaria in pregnancy had a significant association with levels of education (p=0.024). Ninety-eight percent had an ITN, mostly (87.1%) received free from the government. All women attended the ANC during their last pregnancy. The coverage of IPT1 was 53.5% and IPTp2 was 41.1%. The proportion of women making more ANC visits decreased with increasing parity.ConclusionThis study showed that the knowledge of the pregnant women on malaria in pregnancy and IPTp was average and is likely to have an impact on the low IPTp coverage. Campaigns that provide educational massages on the risk of malaria during pregnancy and the usefulness of IPTp need to be emphasised.
Highlights
Universal access to and utilization of malaria prevention measures is defined as every person at malaria risk sleeping under a quality insecticide-treated mosquito net (ITN) and every pregnant woman at risk receiving at least two doses of sulfadoxine-pyrimethamine (SP)
Malaria infection during pregnancy can result in maternal death, maternal anaemia, low birth weight, pre-term birth and sometimes early infant death [2,3,4,5,6,7,8]
The current World Health Organization strategies to prevent and reduce malaria transmission in pregnant women include the use of intermittent preventive treatment in pregnancy (IPTp) and insecticide-treated nets (ITNs) [9]
Summary
Universal access to and utilization of malaria prevention measures is defined as every person at malaria risk sleeping under a quality insecticide-treated mosquito net (ITN) and every pregnant woman at risk receiving at least two doses of sulfadoxine-pyrimethamine (SP). Malaria in pregnancy is one of the major public health problems in endemic areas of sub-Saharan Africa and has important consequences on birth outcomes [1]. The current World Health Organization strategies to prevent and reduce malaria transmission in pregnant women include the use of intermittent preventive treatment in pregnancy (IPTp) and insecticide-treated nets (ITNs) [9]. Diagnosis and proper case management compliment the preventive strategies. The IPTp doses are delivered at health facilities during Antenatal Care (ANC) visits. Despite the high proportion of women who attend ANC services during their pregnancy, those who receive IPTp as per guidelines are still very few. In most cases only the first dose is well covered [9]
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