Determinants of intermittent preventive treatment of malaria among women attending antenatal clinics in primary health care centers in Ogbomoso, Oyo State, Nigeria.

Adefisoye Oluwaseun Adewole,Patrick Nguku,Olufemi Ajumobi,Endie Waziri,Abisola Oladimeji,Olufunmilayo Fawole,Ike Oluwapo Ajayi,Bidemi Yusuf

doi:10.11604/pamj.2019.33.101.14800

Adefisoye Oluwaseun Adewole, Patrick Nguku + Show 6 more

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https://doi.org/10.11604/pamj.2019.33.101.14800

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Journal: The Pan African Medical Journal	Publication Date: Jan 1, 2019
Citations: 12	License type: cc-by

Abstract

IntroductionDespite the effectiveness of intermittent preventive treatment in pregnancy using sulphadoxine-pyrimethamine (IPTp-SP), the uptake and coverage in southwest Nigeria are low. We assessed the factors influencing utilisation of IPTp-SP.MethodsA multistage sampling technique was used to select 400 pregnant women from six primary healthcare centers in Oyo State. Data on socio-demographic characteristics, knowledge, attitude towards IPTp-SP and its utilisation were obtained using a semi-structured questionnaire. Data were analyzed using SPSS software. Focus group discussions (FGD) and key informant interviews (KII) were held for pregnant women and healthcare workers and analysed thematically.ResultsMean age of respondents was 27.2 (SD ± 5.5) years. Mean gestational age was 29.5 weeks (SD ± 5.4). Overall, 320 (80.0%) took SP, of which 152 (47.5%) took 2 doses and 112 (35.0%) took under directly observed therapy (DOT). We found that early booking for ANC, more than two visits to ANC (adjusted odds ratio (aOR) = 5.6; 95% CI: 1.2 - 26.6), good knowledge on IPTp (aOR = 9.3; 95% CI: 5.4 - 16.0), positive attitude towards IPTp (aOR = 2.1; 95% CI: 1.5 - 2.9) and being employed (aOR = 1.4; 95% CI: 1.1 - 1.7) were factors associated with IPTp-SP utilisation. The FGD and KII revealed that IPTp-SP drugs were mostly taken at home due to stock out.ConclusionLate ANC booking with stock out of IPTp-SP drugs was responsible for its low utilisation. There is need to encourage pregnant women to book early for ANC. Adherence to the practice of DOT scheme is recommended to improve IPTp-SP utilisation.

Highlights

Malaria is a major public health problem with the greatest impact of its burden being in sub-Saharan Africa which accounts for 90% of the global deaths [1]
"Pregnant women start coming to the clinic early in pregnancy by 3 months so as to receive good care" (FGD OjaIgbo)
Regarding what directly observed therapy (DOT) scheme meant, all the six health facility heads said it is Directly Observed Therapy, and it meant the administration of SP to an eligible pregnant woman in the presence of a healthcare worker at the clinic during the antenatal visit

Summary

Introduction

Malaria is a major public health problem with the greatest impact of its burden being in sub-Saharan Africa which accounts for 90% of the global deaths [1]. The World Health Organisation (WHO) and national guideline recommendations on malaria infection during pregnancy include use of intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP) at each routine antenatal clinic (ANC) visit at least one month apart after the first trimester till delivery [6]. It should be administered under supervision during ANC visits. In Oyo State, 11% of pregnant women received any SP during an ANC visit while 3% took two or more doses of SP and 1.9% three doses or more of SP [9] To address this inadequacy, identification of determinants of IPTp-SP utilisation is critical to the institution of control efforts. We carried out a study to assess factors influencing the utilisation of intermittent preventive treatment in pregnancy in Ogbomoso, Oyo State, Nigeria

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