Factors associated with optimal uptake of sulphadoxine-pyrimethamine in pregnancy: a facility-based cross-sectional study in the Ningo-Prampram district of Ghana

Abstract

Background: Malaria is endemic throughout Ghana, with children under five years and pregnant women being the most at risk of the severe form of the disease. The Ghana malaria control programme recommends a minimum of five doses of intermittent preventive treatment of malaria during pregnancy using sulphadoxine pyrimethamine (IPTp-SP). Available data show that IPTp-SP uptake in the Ningo-Prampram district is much lower than the regional and national averages. Method:A facility-based cross-sectional analytic study was conducted to assess client and service provider factors associated with uptake of five doses of SP using the mixed method. Results: A total of 457 nursing mothers who had delivered within a period of six months, aged 15- 45 years participated in the study. Uptake of five doses of SP was 15.3% (70/457) with 27 of the women (5.91%) not receiving any dose of SP. Among those who received the drug, 207 (48.14%) took the first dose at week 16 of gestation. The average number of ANC visits made was 5.71 (range 0- 13), with 26.7% (122/457) making the minimum recommended eight ANC visits. Seven of the women did not attend ANC at all during their most recent pregnancy. The gestational age at taking first dose of SP (AOR 0.31, 95% CI:0.15-0.62), the number of ANC sessions attended (AOR 3.8, 95% CI: 2.05-7.05) and the level of knowledge of the mother about IPTp-SP (AOR 2.51, 95% CI:1.25-5.04) were significantly associated with receiving five doses of SP. Conclusion: The level of uptake of five doses of SP was low. Encouraging women to initiate ANC early during pregnancy and also to make more visits through health education by midwives could help improve uptake of IPTp-SP in the Ningo-Prampram district of Ghana and other similar settings.