Predictors of knowledge and use of long-lasting insecticidal nets for the prevention of malaria among the pregnant women in Pakistan

Abstract Background Malaria is endemic to Pakistan with high prevalence among pregnant women and linked with maternal anaemia, intrauterine growth retardation, preterm birth, and low birth weight. The use of long-lasting insecticidal nets (LLINs) is a proven and cost-effective intervention preventing malaria among pregnant women. The present study aimed to explore predictors of knowledge and use of LLINs among pregnant women in Pakistan. Methods This was part of a quasi-experimental study of 200 pregnant women conducted in a rural district of Sindh province in Pakistan. Data were collected using Malaria Indicator Survey questionnaires developed by Roll Back Malaria Partnership to end Malaria Monitoring and Evaluation Reference Group. Pregnant women and mothers with newborns of six months of age were interviewed in their homes. Results The age of the women was from 18 to 45, two thirds of the respondents (72.5%) were uneducated and married (77%). Majority (92%) of the women had received antenatal care during pregnancy, and 29.5% women had received counseling on malaria during their antenatal care visits. Multiple linear regression showed that the type of latrine was the most significant (β = 0.285, p < 0.001) determinant of knowledge about malaria among pregnant women followed by the death of a newborn (β = 0.271, p < 0.001). The use of mobile phone was the most significant (β = 0.247, p < 0.001) predictor of usage of LLINs among pregnant women followed by the death of a newborn (β = 0.232, p < 0.05). Conclusions Maternal education, type of latrine, use of mobile phone, malaria during previous pregnancy and newborn death were strong predictors of knowledge and use of LLINs in pregnant women in Pakistan. There is a need to scale-up programmes that aim to create awareness regarding malaria among pregnant women. Mobile phone technology can be used to implement awareness programmes focusing on malaria prevention among women.

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Analisis Faktor yang Berhubungan dengan Kinerja Bidan dalam Memberikan Pelayanan Antenatal Berkualitas Diwilayah Kerja Puskesmas Kota Bukittinggi Tahun 2018

Jurnal Ilmiah Universitas Batanghari Jambi ◽

10.33087/jiubj.v19i1.545 ◽

2019 ◽

Vol 19 (1) ◽

pp. 53

Author(s):

Khairan Nisa ◽

Joserizal Serudji ◽

Delmi Sulastri

Keyword(s):

Data Analysis ◽

Antenatal Care ◽

Pregnant Women ◽

Monitoring And Evaluation ◽

Dominant Factor ◽

The Public ◽

Depth Interview ◽

Quantitative Data Analysis

Quality antenatal care has a major role in reducing maternal mortality. Every effort to improve quality must also be accompanied by efforts to pay attention to factors that contribute to improving the performance of midwives in providing services. The study used a combination of quantitative approaches in 67 midwives in the Bukittinggi and qualitatively in 15 informants, of which 9 people included in-depth interview informants to coordinator midwives, head of the Public health center and staffing and 6 FGD informants to midwives on duty at the health center.The results of quantitative data analysis, factors related to the performance of midwives are incentives, motivation and workload. Motivation is the most dominant factor related to the performance of midwives. The results of qualitative data analysis, the leadership plays an important role in increasing motivation to work midwives and optimizing the role of midwives in overcoming problems related to overlapping workloads. Midwives also need to increase their participation efforts and empower pregnant women so that programs can run well and provide positive feedback for improving the health status of pregnant women. Basically antenatal services provided by midwives are in accordance with standards, but the paradigm of antenatal care for pregnant women must shift from achieving quantity to focus on quality. To improve the performance of midwives in providing antenatal care, several efforts are needed: monitoring and evaluation of the quality of antenatal care by midwives, leadership involvement in efforts to increase midwife motivation both from supervision and reward management in non-material forms. Providing equal opportunities for midwives to improve competence through training, especially training related to quality antenatal care. In addition, the provision of infrastructure at the polindes needs attention.

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PO 7167 IMPROVING USE OF LONG-LASTING INSECTICIDAL NETS IN KAYANGE COMMUNITY OF NORTH-WESTERN BURUNDI: A QUALITY IMPROVEMENT STUDY

BMJ Global Health ◽

10.1136/bmjgh-2019-edc.49 ◽

2019 ◽

Vol 4 (Suppl 3) ◽

pp. A20.1-A20

Author(s):

Desire Habonimana ◽

Gabriel Ndayisaba ◽

Gideon Nimako

Keyword(s):

Quality Improvement ◽

General Population ◽

Pregnant Women ◽

Cost Effective ◽

Universal Coverage ◽

Malaria Prevention ◽

Quality Improvement Intervention ◽

Long Lasting Insecticidal Nets ◽

North Western ◽

Children Under 5

BackgroundThe use of long-lasting insecticidal nets (LLINs) for malaria prevention is a cost-effective intervention. WHO recommends universal coverage and use of LLINs. In lower- and middle-income countries, LLINs are provided free of charge but are either not used or misused. Our study sought to improve LLIN use in Kayange community of north-western Burundi by using a model for improvement (MFI).MethodsA one-group, pre/post-test study was conducted. LLIN weekly use was assessed for four weeks before intervention and for another four weeks after intervention. The study was conducted in 96 households. The intervention consisted of testing four different weekly small change actions by using the MFI.ResultsOf the 96 households, 83 households (87%) owned at least one LLIN. However, only 40 households (42%) owned at least one LLIN for every two people. After intervention, the number of LLINs used increased from 32 to 75 per cent (134% increase) and the number of persons (general population) sleeping under LLIN from 35 to 73 per cent (108% increase). The number of children under 5 years old sleeping under LLIN increased from 31 to 76 per cent (145% increase) and the number of pregnant women who slept under LLIN from 43 to 73 per cent (69% increase). Also, the averages of the number of nights in each week that the general population slept under LLIN increased from 2.13 to 5.11 (140% increase), children under 5 years old slept under LLIN from 1.68 to 4.78 (184% increase) and pregnant women slept under LLIN from 1.56 to 4.47 (186% increase).ConclusionOur intervention led to significant increase in all outcome indicators. This increase is the result of a combination of an enabling context and an effective implementation of an evidence-based quality improvement intervention. Small tests of change at the community level have the potential for achieving improved outcomes.

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Self-Reported Diabetes Or Hypertension Diagnoses And Antenatal Care Among Child-Bearing Women In Rural Bangladesh: A Cross-Sectional Study

10.21203/rs.3.rs-964052/v1 ◽

2021 ◽

Author(s):

Allyson P. Bear ◽

Wendy L. Bennett ◽

Joanne Katz ◽

Kyu Han Lee ◽

Atique Iqbal Chowdhury ◽

...

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Reference Group ◽

Wealth Quintile ◽

Diabetes Diagnosis ◽

Care Seeking ◽

National Guidelines ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Rural Bangladesh

Abstract Background: Health care systems in limited resource settings may not meet the needs of pregnant women where the burden of diabetes and hypertension is rapidly increasing. We described screening and diagnosis of diabetes or hypertension among recently pregnant women in rural Bangladesh and the antenatal care received.Methods: We asked recently pregnant women about ever having been screened for or diagnosed with hypertension or diabetes and their antenatal care-seeking experiences in a cross-sectional survey in the Baliakandi, Bangladesh. We used chi-squared tests and logistic regression to test the associations between self-reported coverage of hypertension and diabetes screening, diagnoses, and elements of antenatal care by age, wealth, educational attainment, and gravidity. Results: Among 4,692 respondents, 97% reported having been screened and 10% of screened women reported a diagnosis of hypertension. Women 30–39 years of age (aOR 3.02, 95% CI 2.00, 4.56) or in the top wealth quintile (aOR 1.70, 95% CI 1.18, 2.44) were more likely to be diagnosed with hypertension compared to reference groups. Any hypertension diagnosis was associated with reporting four or more antenatal care contacts (44% vs. 35%, p < 0.01), blood pressure measurements (85% vs. 79%, p < 0.01), and urine (71% vs. 61%, p < 0.01) tests conducted during antenatal care visits.For diabetes, 46% of respondents reported having been screened and 3% of screened women reported a diagnosis. Women 30–39 years of age were more likely to be diagnosed with diabetes (aOR 8.19, 95% CI 1.74, 38.48) compared to the reference group. Any diabetes diagnosis was associate with reporting four or more antenatal care contacts (48% vs. 36%, p = 0.04) and having blood testing during pregnancy (83% vs. 66%, p < 0.01). However, the frequency and quality of antenatal care was below the national guidelines among all groups.Conclusion: Focused efforts to ensure that women receive the recommended number of antenatal care contacts, coupled with improved compliance with antenatal care guidelines (including universal screening for diabetes at 24–28 weeks of pregnancy), would improve awareness of hypertension and diabetes among women in Bangladesh.

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Elimination of mother-to-child transmission of syphilis: Is it a reality in Nigeria by 2020?

Scandinavian Journal of Public Health ◽

10.1177/1403494817744988 ◽

2017 ◽

Vol 46 (8) ◽

pp. 794-797 ◽

Cited By ~ 1

Author(s):

Daniel A. Adeyinka ◽

Babayemi O. Olakunde ◽

Chamberline E. Ozigbu ◽

Emmanuel A. Agogo ◽

Mercy Morka ◽

...

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Congenital Syphilis ◽

Scale Up ◽

Mother To Child Transmission ◽

Child Transmission ◽

Treatment Coverage ◽

Syphilis Screening ◽

Maternal Syphilis ◽

Mother To Child

Background: Congenital syphilis is a global health problem, yet it has received little attention in recent years. Despite cost-effective syphilis screening and treatment, it continues to contribute hugely to perinatal morbidity and mortality worldwide. Aims: To determine the prevalence and treatment coverage trend for syphilis among pregnant women in the national prevention of mother-to-child transmission programme in Nigeria and to evaluate progress towards the elimination of congenital syphilis in the country. Methods: A retrospective analysis of validated national health sector performance data on pregnant women attending antenatal care at prevention of mother-to-child transmission clinics from 2013 to 2016 in Nigeria. Results: The proportion of new antenatal care attendees who annually received serological testing for syphilis increased from 12.2% in 2013 to 16.3% in 2016 (p-trend<0.0001). Although the prevalence of maternal syphilis decreased from 3.2% in 2013 to 1.4% in 2016 (p-trend<0.0001), the syphilis treatment coverage during pregnancy has decreased from 71.3% in 2013 to 54.9% in 2016 (p-trend<0.0001). Conclusions: Maternal syphilis screening and treatment in Nigeria are inadequate to meet the elimination aspirations. A rapid scale-up of antenatal care syphilis screening and treatment are crucial to averting an epidemic in Nigeria by 2020.

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Prevalence of PfDHFR and PfDHPS Mutations Associated with Drug Resistance Among Pregnant Women Receiving IPTp-SP at Msambweni County Referral Hospital, Kwale County, Kenya

10.21203/rs.2.17951/v1 ◽

2019 ◽

Author(s):

Stella Wanjiku Gikunju ◽

Eric L. Agola ◽

Raphael Omusebe Ondondo ◽

Johnson Kangethe Kinyua ◽

Francis Kimani ◽

...

Keyword(s):

Drug Resistance ◽

Antenatal Care ◽

Pregnant Women ◽

Venous Blood ◽

Malaria Prevention ◽

Referral Hospital ◽

High Prevalence ◽

Malaria During Pregnancy ◽

Resistance Markers ◽

Treat All

Abstract Background: Prevention and treatment of malaria during pregnancy is crucial in dealing with maternal mortality and adverse fetal outcomes. WHO’s recommendation to treat all pregnant women with sulphadoxine-pyrimethamine (SP) through antenatal care structures was implemented in Kenya in the year 1998 but concerns about its effectiveness in preventing malaria in pregnancy has arisen due to the spread of parasites resistant to SP. We aimed to determine the prevalence of SP resistance markers in Plasmodium falciparum parasites isolated from pregnant women seeking antenatal care at Msambweni County Referral Hospital, located in coastal Kenya, between the year 2013 and 2015. Methods: This hospital-based study included 106 malaria positive whole blood samples for analysis of SP resistance markers within the PfDHFR gene (codons 51,59 &108) and PfDHPS gene (codons 437 & 540). The venous blood collected from all pregnant women was tested for malaria via light microscopy, then thereafter separated into plasma and red cells and stored in a -86⁰ freezer for further studies. Archived red blood cells were processed for molecular characterization of SP resistance markers within the PfDHFR gene and PfDHPS using real time PCR platform. Results: All samples had at least one mutation in the genes associated with drug resistance; polymorphism prevalence of PfDHFR51I, 59R and 108N was at 88.7%, 78.3% and 93.4%, respectively, while PfDHPS polymorphism accounted for 94.3% and 91.5% at 437G and 540K, respectively. Quintuple mutations (at all the five codons) conferring total SP resistance had the highest prevalence of 86%. Quadruple mutations were observed at a frequency of 10.4%, and 24.5% had a heterogeneous outcome with both wildtype and mutant genotypes in the genes of interest. Conclusion: The data suggest a high prevalence of Pf genetic variations conferring resistance to SP among pregnant women, which may explain reduced efficacy of IPTp treatment in Kenya. There is need for extensive SP resistance profiling in Kenya to inform IPTp drug choices for successful malaria prevention during pregnancy.

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Spatial distribution and associated factors of antenatal care utilization in Ethiopia in 2019: Spatial and multilevel analysis

10.21203/rs.3.rs-537337/v1 ◽

2021 ◽

Author(s):

Samuel Hailegebreal ◽

Girma Gilano ◽

Binyam Tariku Seboka ◽

Mohammedjud Hassen Ahmed ◽

Atsedu Endale Simegn

Keyword(s):

Spatial Distribution ◽

Antenatal Care ◽

Odds Ratio ◽

Associated Factors ◽

Maternal Education ◽

Scale Up ◽

Care Utilization ◽

Mixed Effect ◽

Associated Factor ◽

Antenatal Care Utilization

Abstract Background: Antenatal care utilization key to reduces pregnant women death and preparing women for birth. In Ethiopian antenatal care utilization was still not meet health sector transformation plan. There was also regional variation of antenatal care services in the country. Therefore, current study was aimed to explore spatial distribution and associated factors of antenatal care utilization in Ethiopia based on the nationally representative EMDHS data.Methods: Secondary data analysis was done on 2019 Ethiopian mini demographic and health survey (EMDHS) data. ArcGIS 10.7 statistical software were used for spatial analysis. Bernoulli model was fitted by applying Kulldorff methods using the StatsCan 9.6.1 software to analyze the purely spatial clusters of ANC utilization. For associated factor mixed effect multilevel logistic regression was fitted. Inter class correlation (ICC), Median odds ratio (MOR), proportional change variance (PVC) and Deviance used for model comparison and fitness. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to declare significant factors of antenatal care utilization.Results: The prevalence of antenatal care utilization in Ethiopia was 75% [95 CI: 73%, 76%] in this study. The spatial distribution of antenatal car utilization was non-random across the country with Global Moran’s Index value of 0.032, and significant P-value(p<0.05). For associated factor secondary and higher education were 4.2 and 6 time greater than that of no formal education women with AOR of 4.2(1.99-8.66) and 6 (1.62-22) respectively. The odds of richest households were 4.2 times AOR (1.08-2.3) and the odds of married, windowed, and divorced women were 6, 8 and 4.4 time more that of single women respectively in utilizing ANC. The odd of women utilizing ANC was 4.2 times AOR (6.25-10.62). Conclusion: The spatial distribution of ANC utilization in Ethiopia is non-random. Maternal education, marital status, wealth index, place of delivery, pregnancy status region and community women education were significant predicter of antenatal care utilization in Ethiopia. Government and non-governmental organization should scale up maternal health services to low-rate area(hotspot) and poorest women.

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Faktor yang Mempengaruhi Kepatuhan Ibu Hamil dalam Melakukan Kunjungan Antenatal Care (ANC) di Layanan Kesehatan.pdf

I Care Jurnal Keperawatan STIKes Panti Rapih ◽

10.46668/jurkes.v2i1.147 ◽

2021 ◽

Vol 2 (1) ◽

pp. 1-12

Author(s):

Ana Setiyorini ◽

Friska Yuliana Sijabat ◽

Maudy Anita Sari

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Family Support ◽

Employment Status ◽

Maternal Age ◽

Maternal Education ◽

Family Income ◽

Information Support ◽

P Value ◽

Maternal Knowledge

Background: Antenatal care (ANC) is a health service from professionals for pregnant women in accordance with service standards that implemented to improve the physical and mental health of pregnant women optimally, so that they able to face childbirth, postpartum periode, exclusive breastfeeding preparation, and periode of reproductive system return to its normal pre-pregnant stage. Mother’s adherence in ANC attendance can detect and treat pregnancy problems which could impact on maternal mortality. Inadequate utilization of health services can be caused by many factors, including knowledge of pregnant women, distance of residence, family income, information from media, family support, and health workers’ factor. Objective: Determined the factors that influence the adherence of pregnant women to ANC attendance at Panti Rini Hospital Yogyakarta Method: This research is a descriptive analytic study with a cross sectional design at Panti Rini Hospital Yogyakarta. The sample in this study were thirty-two of third trimester pregnant women who visited antenatal care during 15 December 2020-6 January 2021 which recruited with an accidental sampling. Univariate, bivariate analysis with the Spearman correlation statistical test used to determine the relationship of each variables (p-value) at the level of significance p <0.05. Results: Factors that influence maternal adherence to ANC attendance were family support (p-value: 0,000). The factors that did not affect were maternal age (p-value: 0.868), maternal education (p-value: 0.644), employment status (p-value: 0.224), maternal knowledge (p-value: 0.175), distance of residence (p-value: 0.613), family income (p-value: 0.921), media information (p-value: 0.233), support from officers (p-value: 0.141). Conclusions: Factors that influence maternal adherence to ANC attendance were family support. The factors that did not affect were maternal age, maternal education, employment status, maternal knowledge, distance of residence, family income, media information, support from officers. It is hoped that the family will always offer support the mother in checking her pregnancy.

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Hubungan kepatuhan antenatal care dengan pemilihan penolong persalinan di Kabupaten Natuna

Berita Kedokteran Masyarakat ◽

10.22146/bkm.7239 ◽

2016 ◽

Vol 32 (12) ◽

pp. 467

Author(s):

Sri Juana ◽

Detty Siti Nurdiati ◽

Atik Triratnawati

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Maternal Education ◽

Health Workers ◽

Multivariable Analysis ◽

Traditional Birth Attendant ◽

Control Program ◽

Health Department ◽

Cross Sectional ◽

Significance Level

Compliance of antenatal care and election of birth helpers in NatunaPurposeThis study aimed to determine the association of ANC (Antenatal care) compliance with birth attendant choice in Natuna.MethodsThis study used a cross-sectional method. The subjects of the research were mothers in Natuna regency 2014. The variables were: independent variable (ANC compliance), the dependent variable (the birth attendant choice), and the control variables (age, maternal education, distance to the health facilities, parity). Data collection used questionnaires and interviews. The data analysis used descriptive and inferential analysis. The bivariable analysis used the chi-square test and multivariable analysis used logistic regression test with 95% of confidence interval (CI) and a significance level of p <0.05.ResultsBivariable and multivariable analysis showed significant correlations between ANC compliance with birth attendant choice. Pregnant women who did not comply doing ANC according to the standard that has been set at least four times had a chance two times more likely to give birth with the traditional birth attendant (TBA) than the pregnant women who complied to implement the ANC during pregnancy. Mothers with low education had a chance two times greater of choosing the TBA as birth attendant than women who are highly educated. Mothers with parity of >2 had a chance 1.9 times greater of choosing the TBA as birth attendant than women with parity ≤2.ConclusionsThere needs to be a control program from the health department working with community health workers to socialize awareness of the importance of the ANC. There needs to be the addition of TBA who are trained and partnered especially in remote areas because it cannot be denied there are still many people who choose TBA as a birth helper.

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Knowledge of risks of malaria in pregnancy on use of ITNs among pregnant women in northern Ghana

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.818 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

F Dun-Dery ◽

C Beiersmann ◽

N Kuunibe ◽

O Müller

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Malaria Prevention ◽

Malaria In Pregnancy ◽

Sub Saharan Africa ◽

Bed Nets ◽

Maternal Knowledge ◽

Itn Use ◽

Malaria Knowledge ◽

In Pregnancy

Abstract Background Every year malaria in pregnancy causes 10,000 maternal mortalities worldwide, 20% of stillbirths, 11% of all new-born deaths and 900,000 low-birth-weight babies in sub-Saharan Africa. Maternal knowledge of malaria risks in pregnancy plays a significant role in malaria prevention. However, it is unknown if this preventable loss of lives and morbidities are caused by lack of knowledge, lack of prevention tools or both. We measured the pregnancy-related risks of malaria knowledge and bed net availability and use among pregnant women in Ghana. Methods We interviewed 770 pregnant women who attended antenatal care in 37 primary care clinics in Ghana from January through May 2019. We integrated this data in a sequential explanatory design with qualitative insights from 6 focus groups with 8 pregnant women each. Results 697/770 questionnaires were analyzed. 67% have general knowledge on malaria prevention but only 19% knew the specific risks on pregnancy outcomes. ITNs were owned by 89%, but only 75% reported to regularly use them. There was a statistically significant correlation between specific risks of malaria knowledge and ITN use (P<.001, OR = 2.0, CI:1.3-3.0). Other factors associated with ITN use were higher income, owning an ITN, higher parity, formal education, religion, and age. Reasons for non-adherence to ITN use include inappropriate hanging infrastructure, discomfort with using an ITN, and use of other prevention alternatives. Conclusions The study demonstrates that maternal knowledge on the risks of malaria in pregnancy significantly influenced their adherence to the use of insecticide-treated bed nets. Key messages The use of ITNs as a prevention method for malaria correlates to the knowledge of mothers about risks of malaria in pregnancy. Antenatal care malaria prevention efforts should focus more on teaching the specific risks of malaria in pregnancy.

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Knowledge of Malaria and Utilization of Its Preventive Measures among Pregnant Women Attending Antenatal Care at a Tertiary Hospital in Port-Harcourt, Nigeria

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2020/v41i1930386 ◽

2020 ◽

pp. 34-46

Author(s):

P. A. Awoyesuku ◽

C. Ohaka ◽

B. Ngeri

Keyword(s):

Pregnant Women ◽

Preventive Measures ◽

Statistical Significance ◽

Malaria Prevention ◽

Tertiary Hospital ◽

Roll Back Malaria ◽

Insecticide Treated Nets ◽

Mosquito Net ◽

Cross Sectional ◽

Significant Difference

Background: Prevention of malaria is a major priority for the roll back malaria partnership which recommends three-pronged approach for reducing the burden of malaria among pregnant women. The WHO framework for malaria prevention during pregnancy in areas of stable malaria transmission recommends IPT, use of ITN, and case management of malaria illness. Objective: This study sought to determine the knowledge of malaria and its preventive measures among pregnant women, assess their utilization of malaria preventive measures and attitude to treatment. To ascertain whether there exists any relationship between their knowledge and practice of prevention. Methodology: An institutional based, cross-sectional study was carried out. 385 consenting participants, between 18-48 years, were interviewed using a structured questionnaire. Information on socio-demographic characteristics, knowledge of malaria and its preventive measures, use of IPT and ownership/use of ITN, and attitude to treatment were recorded. Data were entered into Excel spreadsheet and analyzed with SPSS version 20. Associations between different variables were determined using Fisher’s exact test or Chi-square test, as appropriate, and logistic regression used to test statistical significance at P<0.05. Results: Of the 385 women, 307 (79.7%) had excellent (18.7%) and good (61%) knowledge, while 78 (20.3%) had average (16.6%) and poor (3.6%) knowledge. There was no difference in association of Knowledge with age, marital status, education, occupation, and parity. Of the 385 women, 61.3% were using IPT for chemoprophylaxis, 66.2% were using insecticide spray or repellants and 71.4% owned mosquito net; of these, 84% owned insecticide treated nets, but only 65.8% were using it in this current pregnancy. Reasons for not using nets ranged from unavailable 49.0%, discomfort due to heat 32.9%, fear of suffocation 6.9%, Spouse’s disapproval 3.9% and 1.0% ineffective. There was statistically significant difference between knowledge and use of IPT, ITN and insecticide sprays. Conclusion: There was adequate knowledge of malaria in pregnancy and its preventive measures, but utilization of these measures needs improvement. Efforts should be made to address barriers to utilization.

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