Factors influencing the use of intermittent preventive treatment of pregnant women seeking care at primary healthcare facilities in the Bwari Area Council, Abuja, Nigeria.

Grace O Peters,Mergan Naidoo

doi:10.4102/phcfm.v12i1.2256

Abstract

BackgroundThe use of intermittent preventive treatment-sulphadoxine–pyrimethamine (IPT-SP), adapted by Nigeria, is one key preventive strategy recommended by the World Health Organization. Because antenatal clinics serve as the usual entry point for IPT-SP implementation, this study explored healthcare workers’ knowledge and practice, which are key to optimal IPT-SP coverage.AimThis study aimed to explore the knowledge and practices of healthcare workers on the direct observation of IPT-SP amongst pregnant women attending antenatal care (ANC) in the Bwari Area Council (BWAC) of the Federal Capital Territory, Abuja, Nigeria.SettingThe study took place at five different wards of Bwari Area Council and eight Antenatal care facilities in Abuja, Federal Capital Territory, Nigeria.MethodsIn-depth interviews and indirect observations were conducted among purposively selected healthcare workers in charge of the ANC of the eligible facilities. The study explored the knowledge and practices of healthcare workers on intermittent preventive treatment. Data were transcribed, translated and manually coded, and thematic analysis was conducted.ResultsHealthcare workers’ knowledge of IPT-SP, mode of administration and the rationale behind the use were poor. They all agreed that IPT-SP is supposed to be administered as a directly observed therapy at the clinic, but this practice was non-existent.ConclusionThe findings indicate that factors such as adequate technical skill, accessibility and availability of logistics influence knowledge and practice of IPT service delivery. Therefore, measures should be put in place to address gaps identified by this study.

Highlights

Malaria in pregnancy is highly prevalent in Africa and constitutes a major public health challenge in sub-Saharan Africa.[1]
Intermittent preventive treatment of malaria in pregnancy (MiP) using sulphadoxine– pyrimethamine (IPT-SP) is one of the three prongs of intervention designed by the World Health Organization to control MiP, especially in malaria-endemic regions where pregnant women are required to receive at least two doses of intermittent preventive treatment-sulphadoxine–pyrimethamine (IPT-SP) as early as possible in the second trimester and at every scheduled antenatal care (ANC) contact thereafter with a month’s interval till birth.[12,13]
A total of eight interviews were conducted among healthcare workers conducting and heading antenatal clinics

Summary

Introduction

Malaria in pregnancy is highly prevalent in Africa and constitutes a major public health challenge in sub-Saharan Africa.[1]. Intermittent preventive treatment of malaria in pregnancy (MiP) using sulphadoxine– pyrimethamine (IPT-SP) is one of the three prongs of intervention designed by the World Health Organization to control MiP, especially in malaria-endemic regions where pregnant women are required to receive at least two doses of IPT-SP as early as possible in the second trimester and at every scheduled antenatal care (ANC) contact thereafter with a month’s interval till birth.[12,13] This assumes that every pregnant woman living in a malaria-endemic area with or without symptoms of malaria has malaria parasites in her blood or placenta, with an increased susceptibility in the second and third trimesters of pregnancy.[9,14] The IPT-SP is to be administered as a directly observed treatment during ANC visits by a qualified healthcare worker.[12] In 2014, Nigeria adopted the updated World Health Organization (WHO) IPT-SP policy of providing IPT-SP from the early second trimester of pregnancy and at each scheduled ANC visit until the time of delivery, provided that the doses are given at least 1 month apart.[15,16] Because antenatal clinics serve as the http://www.phcfm.org. The use of intermittent preventive treatment-sulphadoxine–pyrimethamine (IPT-SP), adapted by Nigeria, is one key preventive strategy recommended by the World Health Organization. Because antenatal clinics serve as the usual entry point for IPT-SP implementation, this study explored healthcare workers’ knowledge and practice, which are key to optimal IPT-SP coverage

Objectives

Results

Discussion

Conclusion