scholarly journals Malaria intermittent preventive treatment in Nigeria: a qualitative study to explore barriers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatima Mahmud Muhammad ◽  
Saharnaz Nedjat ◽  
Haniye Sadat Sajadi ◽  
Mahboubeh Parsaeian ◽  
Abraham Assan ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
Sampling Strategy ◽  
Preventive Treatment ◽  
Group Discussions ◽  
Content Analysis Method ◽  
Conventional Content Analysis ◽  
Sulphadoxine Pyrimethamine ◽  
Selection Of

Abstract Background While the use of sulphadoxine pyrimethamine (SP) is effective in preventing malaria infection during pregnancy, there are challenges limiting its uptake in Nigeria. This study aimed at exploring the barriers to IPTp usage among pregnant women in Kano state - Nigeria. Methods This is a qualitative study. The purposive sampling strategy was used for identification and selection of 14 key informants for interviews. In addition, six focus group discussions (FGDs) were conducted with pregnant women (3 FGDs) and married men (3 FGDs). The conventional content analysis method was used to interpret meaning from the content of the data. MAXQDA 10 software was used for data management and analysis. Results Poor policy implementation, poor antenatal care attendance, inadequate access to intermittent preventive treatment at the community levels, lack of sustainable funding, and poor community engagement emerged as major barriers to IPTp use in Nigeria. Conclusion While the political will to allocate sufficient financial resources could help improve service delivery and IPTp usage among pregnant women, community participation is critical to sustain the gains.

scholarly journals Malaria Intermittent Preventive Treatment in Nigeria: A Qualitative study to explore barriers

2020 ◽  
Author(s):  
Fatima Muhammad Mahmud ◽  
Saharnaz Nedjat ◽  
Haniye Sadat Sajadi ◽  
Mahboubeh Parseian ◽  
Reza Majdzadeh ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
Sampling Strategy ◽  
Preventive Treatment ◽  
Group Discussions ◽  
Content Analysis Method ◽  
Married Men ◽  
Conventional Content Analysis ◽  
Sulphadoxine Pyrimethamine

Abstract Background: While the use of sulphadoxine pyrimethamine (SP) is effective in preventing malaria infection during pregnancy, challenges exist which limits its uptake in Nigeria. This study aimed to explore the barriers of IPTp use among pregnant women in Kano state, Nigeria.Methods: This is a qualitative study. We employed the purposive sampling strategy to select 14 key informants for interview. We also conducted three focus group discussions (FGD) with pregnant women, and married men. The conventional content analysis method was used. MAXQDA 10 software was used for data management and analysis, i.e., to develop categories, subcategories and codes.Results: Poor policy implementation, poor antenatal care attendance, inadequate access to intermittent preventive treatment at the community levels, lack of sustainable funding and poor community engagement emerged as major barriers to IPTp use.Conclusion:While the political will to allocate sufficient financial resources could help improve service delivery and IPTp use among pregnant women, community participation is also critical to sustain gains.

scholarly journals Using equity lens to explore Malaria Intermittent Preventive Treatment in Nigeria: A Qualitative study

2020 ◽  
Author(s):  
Fatima Muhammad Mahmud ◽  
Saharnaz Nedjat ◽  
Haniye Sadat Sajadi ◽  
Mahbubeh Parsaeian ◽  
Reza Majdzadeh
Keyword(s):  
Qualitative Study ◽  
Service Delivery ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Intermittent Preventive Treatment ◽  
Sampling Strategy ◽  
Preventive Treatment ◽  
Barriers And Facilitators ◽  
Care Providers ◽  
Sulphadoxine Pyrimethamine

Abstract Background : Sulphadoxine pyrimethamine (SP) used as a preventive treatment for malaria is low among pregnant women in Nigeria. However, there is limited evidence on the barriers and facilitators of intermittent preventive treatment (IPTp) use in pregnant women. Thus, this study aimed to explore the barriers and facilitators of IPTp use among pregnant women in Kano state, Nigeria.Methods: This qualitative study used a conventional content analysis method. Purposeful sampling strategy was used to select study participants. A total of 14 key informant interviews were conducted with policy makers, malaria experts and health care providers. Three focus group discussions (FGD) were also conducted among pregnant women. Furthermore, separate three FGDs were conducted among husbands whom were selected using opportunistic maximum variation sampling method. The data were analyzed with MaxqDA 10 software which was used to develop the categories, subcategories and themes.Results: A total of five main categories, 13 subcategories, and 17 themes were identified. Malaria policy implementation, antenatal care attendance, accessibility of intermittent preventive treatment in the communities, strengthening IPTp service delivery were the main facilitators of IPTp use. However, political reluctance, high population density, inadequate budget to implement IPTp related policies were the main barriers of IPTp use.Conclusion: This study revealed key barriers and facilitators of the use of Intermittent preventive treatment using Sulphadoxine pyrimethamine. Our study findings suggest that any strategy for improving the of IPTp use among pregnant women should focus on political reluctance, inadequate budget and strengthen the service delivery

scholarly journals Malaria Intermittent Preventive Treatment in Nigeria: A Qualitative study to explore barriers and facilitators

2020 ◽  
Author(s):  
Fatima Muhammad Mahmud ◽  
Saharnaz Nedjat ◽  
Haniye Sadat Sajadi ◽  
Mahbubeh Parseian ◽  
Reza Majdzadeh
Keyword(s):  
Qualitative Study ◽  
Service Delivery ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Intermittent Preventive Treatment ◽  
Sampling Strategy ◽  
Preventive Treatment ◽  
Barriers And Facilitators ◽  
Care Providers ◽  
The Sustainable Development

Abstract Background : Sulphadoxine pyrimethamine (SP) used as a preventive treatment for malaria is low among pregnant women in Nigeria. However, there is limited evidence on the barriers and facilitators of intermittent preventive treatment (IPTp) use in pregnant women. This study aimed to explore the barriers and facilitators of IPTp use among pregnant women in Kano state, Nigeria.Methods: This qualitative study used a conventional content analysis method. Purposive sampling strategy was used to select study participants. A total of 14 key informant interviews were conducted with policy makers, malaria experts and health care providers. Three focus group discussions (FGD) were also conducted among pregnant women. Furthermore, separate three FGDs were conducted among husbands whom were selected using opportunistic maximum variation sampling method. MaxqDA 10 software was used for data analysis, i.e., to develop categories, subcategories and themes.Results: Malaria policy implementation, antenatal care attendance, accessibility of intermittent preventive treatment in the communities, strengthening IPTp service delivery were the facilitators of IPTp use while political reluctance, high population density, inadequate budget to implement IPTp related policies emerged as barriers to IPTp use.Conclusion: The political will to allocate sufficient budget could help improve service delivery and IPTp use among pregnant women and facilitate the achievement of the Sustainable Development Agenda to end malaria in 2030.

scholarly journals Malaria Intermittent Preventive Treatment in Nigeria: A Qualitative study to explore barriers and facilitators

2020 ◽  
Author(s):  
Fatima Muhammad Mahmud ◽  
Saharnaz Nedjat ◽  
Haniye Sadat Sajadi ◽  
Mahbubeh Parseian ◽  
Reza Majdzadeh
Keyword(s):  
Qualitative Study ◽  
Service Delivery ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Intermittent Preventive Treatment ◽  
Sampling Strategy ◽  
Preventive Treatment ◽  
Barriers And Facilitators ◽  
Care Providers ◽  
The Sustainable Development

Abstract Background : Sulphadoxine pyrimethamine (SP) used as a preventive treatment for malaria is low among pregnant women in Nigeria. However, there is limited evidence on the barriers and facilitators of intermittent preventive treatment (IPTp) use in pregnant women. This study aimed to explore the barriers and facilitators of IPTp use among pregnant women in Kano state, Nigeria. Methods: This qualitative study used a conventional content analysis method. Purposive sampling strategy was used to select study participants. A total of 14 key informant interviews were conducted with policy makers, malaria experts and health care providers. Three focus group discussions (FGD) were also conducted among pregnant women. Furthermore, separate three FGDs were conducted among husbands whom were selected using opportunistic maximum variation sampling method. MaxqDA 10 software was used for data analysis, i.e., to develop categories, subcategories and themes. Results: Malaria policy implementation, antenatal care attendance, accessibility of intermittent preventive treatment in the communities, strengthening IPTp service delivery were the facilitators of IPTp use while political reluctance, high population density, inadequate budget to implement IPTp related policies emerged as barriers to IPTp use. Conclusion: The political will to allocate sufficient budget could help improve service delivery and IPTp use among pregnant women and facilitate the achievement of the Sustainable Development Agenda to end malaria in 2030. Key words: Malaria , Intermittent preventive treatment, Equity, Pregnant women, Nigeria.

scholarly journals Socioeconomic inequality in intermittent preventive treatment using Sulphadoxine pyrimethamine among pregnant women in Nigeria

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fatima Mahmud Muhammad ◽  
Reza Majdzadeh ◽  
Saharnaz Nedjat ◽  
Haniye Sadat Sajadi ◽  
Mahboubeh Parsaeian
Keyword(s):  
Pregnant Women ◽  
Concentration Index ◽  
Socioeconomic Inequality ◽  
Intermittent Preventive Treatment ◽  
Wealth Index ◽  
Preventive Treatment ◽  
Educational Status ◽  
P Value ◽  
Contributing Factors ◽  
Sulphadoxine Pyrimethamine

Abstract Background Intermittent preventive treatment using Sulphadoxine pyrimethamine (IPTp-SP) for malaria prevention is recommended for all pregnant women in malaria endemic areas. However, there is limited evidence on the level of socioeconomic inequality in IPTp-SP use among pregnant women in Nigeria. Thus, this study aimed to determine the level of socioeconomic inequality in IPTp-SP use among pregnant women in Nigeria and to decompose it into its contributing factors. Methods A secondary data analysis of Nigerian demographic and health survey of 2018 was conducted. A sample of 21,621 pregnant women aged between 15 and 49 years and had live birth in the previous 2 years before the survey were included in this analysis. The study participants were recruited based on a stratified two-stage cluster sampling method. Socioeconomic inequality was decomposed into its contributing factors by concentration index. Result Totally 63.6% of pregnant women took at least one dose of IPTp-SP prophylaxis. Among IPTp-SP users, 35.1% took one dose, 38.6% took two doses and 26.2% took three doses and more. Based on both concentration index of 0.180 (p-value = < 0.001, 95% CI: 0.176 to 0.183) and Erreyger’s normalization concentration index 0.280 (p-value = < 0.001, 95% CI: 0.251 to 0.309), the IPTp-SP utilization was pro-rich. The largest contributors to the inequality in IPTp-SP uptake were wealth index (47.81%) and educational status (28.66%). Conclusion Our findings showed that IPTp-SP use was pro-rich in Nigeria. Wealth index and educational status were the factors that significantly contributed to the inequality. The disparities could be reduced through free IPTp service expansion by targeting pregnant women from low socioeconomic status.

scholarly journals Molecular markers of resistance to sulphadoxine-pyrimethamine during intermittent preventive treatment of pregnant women in Benin

2011 ◽  
Vol 10 (1) ◽  
pp. 196 ◽  
Author(s):  
Gwladys Bertin ◽  
Valérie Briand ◽  
Diana Bonaventure ◽  
Ambre Carrieu ◽  
Achille Massougbodji ◽  
...  
Keyword(s):  
Molecular Markers ◽  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Sulphadoxine Pyrimethamine

scholarly journals Intermittent preventive treatment comparing two versus three doses of sulphadoxine pyrimethamine (IPTp-SP) in the prevention of anaemia in pregnancy in Ghana: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250350
Author(s):  
Yaa Nyarko Agyeman ◽  
Sam Newton ◽  
Raymond Boadu Annor ◽  
Ellis Owusu-Dabo
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Anaemia In Pregnancy ◽  
Sulphadoxine Pyrimethamine ◽  
In Pregnancy

In 2012 the World Health Organisation (WHO) revised the policy on Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPTp-SP) to at least three doses for improved protection against malaria parasitaemia and its associated effects such as anaemia during pregnancy. We assessed the different SP dosage regimen available under the new policy to determine the dose at which women obtained optimal protection against anaemia during pregnancy. A cross-sectional study was conducted among pregnant women who attended antenatal clinic at four different health facilities in Ghana. The register at the facilities served as a sampling frame and simple random sampling was used to select all the study respondents; they were enrolled consecutively as they kept reporting to the facility to receive antenatal care to obtain the required sample size. The haemoglobin level was checked using the Cyanmethemoglobin method. Multivariable logistic regression was performed to generate odds ratios, confidence intervals and p-values. The overall prevalence of anaemia among the pregnant women was 62.6%. Pregnant women who had taken 3 or more doses of IPTp-SP had anaemia prevalence of 54.1% compared to 66.6% of those who had taken one or two doses IPTp-SP. In the multivariable logistic model, primary (aOR 0.61; p = 0.03) and tertiary education (aOR 0.40; p = <0.001) decreased the odds of anaemia in pregnancy. Further, pregnant women who were anaemic at the time of enrollment (aOR 3.32; p = <0.001) to the Antenatal Care clinic and had malaria infection at late gestation (aOR 2.36; p = <0.001) had higher odds of anaemia in pregnancy. Anaemia in pregnancy remains high in the Northern region of Ghana. More than half of the pregnant women were anaemic despite the use of IPTp-SP. Maternal formal education reduced the burden of anaemia in pregnancy. The high prevalence of anaemia in pregnancy amid IPTp-SP use in Northern Ghana needs urgent attention to avert negative maternal and neonatal health outcomes.

scholarly journals Effectiveness of intermittent preventive treatment in pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) in Ghana

2021 ◽  
Vol 6 (8) ◽  
pp. e005877
Author(s):  
David Kwame Dosoo ◽  
Kezia Malm ◽  
Felix Boakye Oppong ◽  
Richard Gyasi ◽  
Abraham Oduro ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Lower Risk ◽  
Dose Group ◽  
Placental Malaria ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Monthly Administration ◽  
To Receive ◽  
Sulphadoxine Pyrimethamine ◽  
In Pregnancy

IntroductionGhana adopted the revised WHO recommendation on intermittent preventive treatment in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) in 2012. This study has assessed the effectiveness and safety of this policy in Ghana.MethodsA total of 1926 pregnant women enrolled at antenatal care (ANC) clinics were assessed for birth outcomes at delivery, and placental histology results for malaria infection were obtained from 1642 participants. Association of reduced placental or peripheral malaria, anaemia and low birth weight (LBW) in women who received ≥4 IPTp-SP doses compared with 3 or ≤2 doses was determined by logistic regression analysis.ResultsAmong the 1926 participants, 5.3% (103), 19.2% (369), 33.2% (640) and 42.3% (817) of women had received ≤1, 2, 3 or ≥4 doses, respectively. There was no difference in risk of active placental malaria (PM) infection in women who received 3 doses compared with ≥4 doses (adjusted OR (aOR) 1.00, 95% CI 0.47 to 2.14). The risk of overall PM infection was 1.63 (95% CI 1.07 to 2.48) in 2 dose group and 1.06 (95% CI 0.72 to 1.57) in 3 dose group compared with ≥4 dose group. The risk of LBW was 1.55 (95% CI 0.97 to 2.47) and 1.06 (95% CI 0.68 to 1.65) for 2 and 3 dose groups, respectively, compared with the ≥4 dose group. Jaundice in babies was present in 0.16%, and 0% for women who received ≥4 doses of SP.ConclusionThere was no difference in the risk of PM, LBW or maternal anaemia among women receiving 3 doses compared with ≥4 doses. Receiving ≥3 IPTp-SP doses during pregnancy was associated with a lower risk of overall PM infection compared with 2 doses. As there are no safety concerns, monthly administration of IPTp-SP offers a more practical opportunity for pregnant women to receive ≥3 doses during pregnancy.

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