Factors Associated With The Adherence To Unsupervised Daily Dose To Seasonal Malaria Chemoprevention In Builsa North District, Upper East Region Of Ghana

Abstract

Background: Since 2015, SMC with amodiaquine–sulfadoxine-pyrimethamine (AQ–SP) has been implemented during the high malaria transmission season in three regions of Ghana. Adherence to the Seasonal Malaria Chemoprevention (SMC) is one of the critical determinants for successfully protecting children under five. In Ghana, there is limited evidence of sociodemographics and awareness factors associated with adherence to SMC. The purpose of this study was to explore the adherence level to SMC and the factors associated with adherence to SMC among caregivers in Builsa North District. Methods: In four (4) sub-district households in the Builsa North District, a cross-sectional study was conducted. The district was stratified into six, and four subdistricts were selected using simple random sampling. The 438 participants were recruited via balloting using a random sampling procedure. Illustrative summary statistics performed for frequencies. The knowledge of caregivers on Malaria and SMC was assessed by scoring correct answers to questions related to malaria and SMC. The association between SMC adherence and independent variables was tested using Pearson's chi-square test and Fisher Exact Test. Simple and multiple logistic regressions were performed to determine associations and strength of associations between SMC adherence and the independent variables, with all results interpreted at 95 % confidence level. Results: The SMC adherence rates among the caregivers in the Builsa North District were respectively 95.36%, with an awareness level of 97.94%. The reasons reported for non-adherence were the child's refusal (38.46%), the child's vomiting of the drug (33.33%), the occurrence of an illness within the period of medication (15.38%), the forgetting to give the subsequent doses (12.82%). About half (49.31%) of caregivers had a good knowledge of malaria, while 66.51% had a fair knowledge of SMC. Significant predictors of SMC on multiple logistic regression were the place of residence, caregivers' satisfaction, and the source of knowledge.Conclusion: The adherence rate to SMC in Builsa North District is 95.36%. The key factors associated with SMC Adherence are being aware of SMC through non-health professional source, place of residence, and caregivers' satisfaction with the previous SMC campaign.