Abstract
Background: In a context of low coverage (around 40%) of malarial intermittent preventive treatment in pregnant women in republic of Benin, we investigated the implication of health center quality and accessibility factors on the compliance with IPTp. Methods: In a cross-sectional study conducted from October 2017 to February 2018 in southern Benin, 422 women, pregnant in the last trimester or who gave birth less than a month ago were included. Conditions of access to the health center and factors related to the quality of services at the health center were collected. To search for associated factors, univariate analysis were performed using Chi2 (or Fisher’s) and Student’s test. Logistic regression model was fitted for multivariate analysis. Results: Rates of IPTp intake were 36.49%, 26.78% and 11.14% respectively for first, second and third doses. Two factors increased the probability of taking IPT: travel cost (OR=2.57 [1.36; 3.92]) and quality of reception at health center (OR=1.93 [1.27; 2.64]). Conversely, the increase in travel time from home to health center was associated with a lower probability of taking IPT (OR=0.91 [0.85; 0.98]). Conclusion: This study highlighted the need to take into account the improvement of the socioeconomic level of women and the improvement of the quality of services in health centers in order to achieve better coverage of IPT taking in pregnant women. Strengthening the health system in developing countries, in particular by recruiting health workers and training them, is beneficial.
Highlights
Malaria is a serious pathology with more than 216 million cases recorded worldwide in 2016, of which sub-Saharan Africa is the most affected with nearly 90% of malaria-related deaths [1, 2]
For antimalarial chemoprophylaxis in pregnant women, European Journal of Preventive Medicine 2021; 9(1): 8-13 especially in endemic regions including sub-Saharan Africa, the World Health Organization (WHO) has recommended for more than a decade, the taking of intermittent preventive treatment (IPT) which is composed of a combination of sulfadoxine-pyrimethamine (SP) and consists of taking supervised by a health worker from the 2nd trimester at each antenatal consultation (ANC) according to the schedule established until childbirth while respecting an interval of at least one month between 2 consecutive intakes [12, 13]
In this study where 422 women were recruited in Ouidah-Kpomassè-Tori Bossito, objectives were to determine the compliance with the recommended doses of IPTp according to health center accessibility and quality
Summary
Malaria is a serious pathology with more than 216 million cases recorded worldwide in 2016, of which sub-Saharan Africa is the most affected with nearly 90% of malaria-related deaths [1, 2]. For antimalarial chemoprophylaxis in pregnant women, European Journal of Preventive Medicine 2021; 9(1): 8-13 especially in endemic regions including sub-Saharan Africa, the World Health Organization (WHO) has recommended for more than a decade, the taking of intermittent preventive treatment (IPT) which is composed of a combination of sulfadoxine-pyrimethamine (SP) and consists of taking supervised by a health worker from the 2nd trimester at each antenatal consultation (ANC) according to the schedule established until childbirth while respecting an interval of at least one month between 2 consecutive intakes [12, 13]. The Benin Republic, a malaria endemic area, has adopted IPT in 2006 but national IPT coverage remains low and stands at 40% This rate is even lower in the Ouidah / Kpomassè / Tori-Bossito health zone, 30 to 35%. Strengthening the health system in developing countries, in particular by recruiting health workers and training them, is beneficial
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