Determinants of timely uptake of ITN and SP (IPT) and pregnancy time protected against malaria in Bukoba, Tanzania

Abstract

ObjectiveInsecticides treated nets (ITNs) and intermittent preventive therapy with two doses of sulfadoxine-pyrimethamine (SP IPTp) are the cornerstone for malaria control in pregnancy. Despite the coverage of these interventions being high, it is not known whether they confer optimal protection time against malaria in pregnancy. This study investigated the timing and determinants of timely uptake of SP(IPTp) and ITNs and the pregnancy time protected.MethodsA health facility based cross-sectional study was carried out in Bukoba urban district from 16th April to 29 May 2013. Involving pregnant women and post natal mothers attending Reproductive and Child Health (RCH) clinics. Data on their socio-economic background, pregnancy history and attendance to RCH, receipt of a voucher and acquisition of an ITN as well as SP for IPTp were collected. Their responses were validated from the records of antenatal cards. Data was analysed using SPSS computer program version 20.ResultsA total of 530 mothers were recruited. The overall uptake of SP IPTp was 96 % and the uptake of two SP (IPTp) doses was 86 %. Timely uptake of 1st dose was predicted by early antenatal booking, [AOR 2.59; 95 % CI 1.51–4.46; P = 0.001], and the availability of SP at the facility [AOR 4.63; 95 % CI 2.51–8.54; P < 0.0001]. Uptake of 2nd dose was independent of any predictor factors. A total of 486 (91.6 %) women received ITNs discount vouchers at different gestational age and of these, less than a quarter (21.4 %) received timely. Timely receipt of discount voucher was highly predicted by early antenatal booking [AOR 200; 95 % CI 80.38–498; P < 0.0001].ConclusionAlthough there is a high coverage of SP IPTp and discount vouchers for ITNs, timely uptake and therefore optimal protection time depended on early antenatal booking, the availability of (SP IPTp) and discount voucher at the health facility.

Use of Intermittent Preventive Treatment among Pregnant Women in Sub-Saharan Africa: Evidence from Malaria Indicator Surveys

“…Data were obtained from the Malaria Indicator Surveys (MIS) conducted in eight sub-Saharan African countries as shown in Figure 1 : Burkina Faso (2014), Ghana (2016), Mali (2015), Malawi (2014), Kenya (2015), Nigeria (2015), Sierra Leone (2016), and Uganda (2014–2015). Surveys were conducted by technical assistance as well as funding by ICF International through the Demographic and Health Survey (DHS) Program, which is a USAID-funded project providing support and technical assistance in the implementation of population and health surveys in countries worldwide [ 21 ].…”

“…Although about 37 countries has so far introduced IPTp policy [ 17 ], poor implementation and enforcement of these policies are reflected through low coverage and disparities in utilisation rates [ 5 , 18 , 19 , 20 , 21 ]. According to a review study conducted in 2009, the rate of antimalarial drugs uptake among pregnant women varied from as low as 2% to more than 60% with significant regional and socioeconomic disparities in utilisation rates [ 22 ].…”

Reaching the unreached: Effectiveness and Satisfaction with Community-Directed Distribution of Suphadoxine-Pyrimethamine for preventing Malaria in Pregnancy in rural South-East, Nigeria

“…Poor antenatal uptake has been identified as a bottleneck to the effective administration of IPTp to pregnant women in developing countries where antenatal utilization tends to be suboptimal [13,14].…”

“…Ebonyi State is located in South-Eastern Nigeria with Abakaliki as the state capital. There are three senatorial zones and 13 LGAs in the state. According to the 2006 population and housing census, the population of Ebonyi state is approximately 2,176,947 with landmass of 5,935 square kilometers.…”

Reaching the unreached: Effectiveness and Satisfaction with Community-Directed Distribution of Suphadoxine-Pyrimethamine for preventing Malaria in Pregnancy in rural South-East, Nigeria

“…Poor antenatal uptake has been identi ed as a bottleneck to the effective administration of IPTp to pregnant women in developing countries where antenatal utilization tends to be suboptimal [13,14].…”