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

Abstract

Introduction Despite 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. Methods A 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. Results Mean 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. Conclusion Late 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.

Recognition and Practice of Home-Management of Malaria among Mothers of Under-Five Children in Obafemi Owode Community, Abeokuta, Ogun State

“…The result is similar to that of McCombie ( 2019) that rural women residing in a resource-constrained environment have good understanding of home treatment of malaria because of the direct and especially indirect costs of seeking health care from formal facilities may be substantial, providing a major barrier for many households and low level of mother's education which has reduced the number of visits to clinics and hospitals. Furthermore, the result is in tandem with the findings of Fawole (2019) that mothers are primary caregivers and are usually the first to recognize signs of illness in their children. It has been demonstrated that educating mothers on malaria recognition and treatment can improve the effectiveness of malaria control programs…”

Late ANC initiation and factors associated with sub-optimal uptake of sulphadoxine-pyrimethamine in pregnancy: a preliminary study in Cape Coast Metropolis, Ghana

“…Early initiation [ 19 ] and high utilization of ANC services are factors that are known to strongly predict IPTp-SP uptake [ 16 ]. In our current study, early initiation of ANC was found to significantly influence uptake of three-five doses of SP as early initiation of ANC resulted in one being able to make the recommended minimum of four visits and therefore able to receive more doses of SP as reported by other investigators [ 4 , 10 , 13 , 16 , 20 ].…”

Determinants of Uptake of Intermittent Preventive Treatment for Malaria With Sulfadoxine Pyrimethamine in Pregnancy: A Cross-Sectional Study in the Sekondi-Takoradi Metropolis of Ghana

“…The high level of early initiation of ANC found in the current study may be due to the fact that a high proportion of the women have secondary to tertiary level education (60%) [23] and possibly having adequate knowledge on IPTp-SP [24]. Most of these women (85.28%) were also gainfully employed [25];…”