Determinants of uptake of first dose of intermittent preventive treatment among pregnant women in a secondary health Centre in Maiduguri, Nigeria

Abstract

Background Studies on uptake of first dose of intermittent preventive treatment in pregnancy (IPTp) are lacking, despite it being a predictor of subsequent doses. This study aimed at assessing the determinants of uptake of first dose of IPTp among pregnant women at the State Specialist Hospital, Maiduguri. Methods A cross-sectional study was conducted, in which respondents were selected using a systematic random sampling method, and structured questionnaires were used to obtain information from them. Chi-squared test was used to determine factors associated with uptake of first IPTp dose, while a further multivariate logistic regression was performed to determine its predictors. Results Three hundred and eighty respondents answered the survey, whose ages ranged from 15 to 45 years, and 86.8% were multigravid. Sixty five percent of them were aware of IPTp, and 34.7% believed that IPTp could be harmful to their pregnancies. Over a half of the respondents (52.9%) believed that taking all their IPTp medicines was very good for their pregnancies, while 45.0% felt that taking their IPTp medicines was very pleasant. Only two respondents (0.5%) stated that it was very untrue that their significant others thought that they should take all their IPTp medicines. Half of the respondents said it was very easy for them to take all their IPTp medicines even if they were experiencing mild discomforts while taking them. Less than a half (42.37%) had received their first dose of IPTp. In bivariate as well as multivariate analysis, only higher level of knowledge was significantly associated with uptake of first IPTp dose. Those with better knowledge of IPTp were about twice more likely to have taken their first dose of IPTp, compared to those with lower knowledge of IPTp (AOR = 1.85; 95% CI: 1.17–2.92). Conclusions Knowledge of IPTp as well as its uptake, were sub-optimal in this study. Since knowledge of IPTp significantly predicts uptake of the first dose of IPTp, there is the need to implement health education campaigns to raise the awareness of pregnant women and their families on the need to receive and comply with it.

Factors associated with the uptake of Intermittent Preventive Treatment (IPTp-SP) for malaria in pregnancy: further analysis of the 2018 Nigeria Demographic and Health Survey

“…This finding aligns with Balami et al, 2020, that knowledge about the efficacy of SP predicts the receipt of the first SP dose. And ultimately, the subsequent IPTp-SP doses during pregnancy (37).…”

“…This finding aligns with Balami et al, 2020, that knowledge about the efficacy of SP predicts the receipt of the first SP dose. And ultimately, the subsequent IPTp-SP doses during pregnancy (37). Also, pregnant women’s awareness of the morbidity caused by malaria predicted higher uptake of at least one SP dose but not optimal doses received.…”

Using Andersen’s Behavioural Model of Health Services use to Examine usage of Intermittent Preventive Treatment of Malaria in Pregnancy in Nigeria

“…Our nding thus suggests that not all con rm cases of malaria among pregnant women are receiving effective care particularly IPTp therapy. The reasons for low usage may probably be due to either poor knowledge of the IPTp by pregnant women [12] or the existence of some health system barriers such as stock out of IPTp and poor training of providers [25,17,10,24,15] which adversely affects utilisation. The Federal Ministry of Health may need to devise additional public health education programme that promote IPTp usage by pregnant women.…”

“…Evidence however shows that in Nigeria and many other sub-Sahara African countries, the uptake of optimal doses of IPTp (3 or more doses) by pregnant women remains low and below national targets [9][10][11][12][13][14][15]. For example, in the 2018 Nigeria Demographic and Health Survey (NDHS), the prevalence of IPTp optimal doses of SP/Fansidar was 17% among childbearing women who had deliveries in the two years preceding the survey.…”

“…This is important because low coverage re ects missed opportunities not only to deliver IPTp to pregnant women [16] but also missed opportunities to reduce adverse maternal and child health outcomes [17] in the country. Studies in Nigeria [18][19][20]12] and elsewhere in sub-Saharan Africa [13][14] have explored the factors in uencing use of IPTp with many of the studies identifying some important determinants of IPTp usage across sub-Saharan Africa. The identi ed determinants among others include type of antenatal care facility, health insurance enrolment, number of antenatal care visits [21], education, parity [22], timing of rst antenatal visit [23], employment [24], place of residence [25], geographical region [13], knowledge of malaria preventive strategies [26], maternal age, and household wealth index [27][28].…”