scholarly journals Factors Influencing Adherence to the New Intermittent Preventive Treatment of Malaria in Pregnancy Policy in Keta District of the Volta Region, Ghana

2019 ◽  
Author(s):  
Alren O. Vandy ◽  
Nana Yaw Peprah ◽  
Joseph Yaw Jerela ◽  
Perfect Titiati ◽  
Abubakar Manu ◽  
...  
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
World Health ◽  
Categorical Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Volta Region ◽  
In Pregnancy

Abstract Background About 25% of pregnant women in malaria endemic areas are infected with malaria and this accounts for about 15% of maternal death globally. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is one of the main strategies for prevention of malaria in pregnancy. A new recommendation was made by World Health Organization (WHO) that at least three doses of IPTp-SP should be administered before delivery. This study sought to determine the factors influencing adherence to the new IPTp-SP policy in Keta District, Volta region, Ghana. Methods A cross-sectional quantitative study among 375 nursing mothers at four selected health facilities in Keta district, Ghana was conducted using a structured questionnaire to interview participants. Data was analyzed using STATA 15. Chi-square was used to test bivariate association between categorical variables and adherence. Logistic regression analysis was used to examine sociodemographic, individual and institutional factors influencing adherence to IPTp-SP. Result About 82.1% of participants adhered to the WHO policy recommendations of at least three doses of IPTp-SP. However, only 17.1% received Ghana’s five dose coverage recommendation. The proportion of IPTp-SP coverage for IPTp1 was 98.9%; IPTp2 95.5%; IPTp3 80.8%; IPTp4 39.5%; IPTp5 17.1%. Conclusion Adherence to IPTp-SP was satisfactory according to WHO’s policy recommendation, however, majority of the participants had less than the five doses recommended in Ghana. Number of ANC visits and knowledge of malaria were the main determinants of adherence to IPTp-SP.

scholarly journals Factors Influencing Adherence to the New Intermittent Preventive Treatment of Malaria in Pregnancy Policy in Keta District of the Volta Region, Ghana

2019 ◽  
Author(s):  
Alren O. Vandy ◽  
Nana Yaw Peprah ◽  
Joseph Yaw Jerela ◽  
Perfect Titiati ◽  
Abubakar Manu ◽  
...  
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
World Health ◽  
Categorical Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Volta Region ◽  
In Pregnancy

Abstract Background About 25% of pregnant women in malaria endemic areas are infected with malaria and this accounts for about 15% of maternal death globally. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is one of the main strategies for prevention of malaria in pregnancy. A new recommendation was made by World Health Organization (WHO) that at least three doses of IPTp-SP should be administered before delivery. This study sought to determine the factors influencing adherence to the new IPTp-SP policy in Keta District, Volta region, Ghana. Methods A cross-sectional quantitative study among 375 nursing mothers at four selected health facilities in Keta district, Ghana was conducted using a structured questionnaire to interview participants. Data was analyzed using STATA 15. Chi-square was used to test bivariate association between categorical variables and adherence. Logistic regression analysis was used to examine sociodemographic, individual and institutional factors influencing adherence to IPTp-SP. Result About 82.1% of participants adhered to the WHO policy recommendations of at least three doses of IPTp-SP. However, only 17.1% received Ghana’s five dose coverage recommendation. The proportion of IPTp-SP coverage for IPTp1 was 98.9%; IPTp2 95.5%; IPTp3 80.8%; IPTp4 39.5%; IPTp5 17.1%. Conclusion Adherence to IPTp-SP was satisfactory according to WHO’s policy recommendation, however, majority of the participants had less than the five doses recommended in Ghana. Number of ANC visits and knowledge of malaria were the main determinants of adherence to IPTp-SP.

scholarly journals Factors Influencing Adherence to the New Intermittent Preventive Treatment of Malaria in Pregnancy Policy in Keta District of the Volta Region, Ghana

2019 ◽  
Author(s):  
Alren O. Vandy ◽  
Nana Yaw Peprah ◽  
Joseph Yaw Jerela ◽  
Perfect Titiati ◽  
Abubakar Manu ◽  
...  
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
World Health ◽  
Categorical Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Volta Region ◽  
In Pregnancy

Abstract Background About 25% of pregnant women in malaria endemic areas are infected with malaria and this accounts for about 15% of maternal death globally. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is one of the main strategies for prevention of malaria in pregnancy. A new recommendation was made by World Health Organization (WHO) that at least three doses of IPTp-SP should be administered before delivery. This study sought to determine the factors influencing adherence to the new IPTp-SP policy in Keta District, Volta region, Ghana. Methods A cross-sectional quantitative study among 375 nursing mothers at four selected health facilities in Keta district, Ghana was conducted using a structured questionnaire to interview participants. Data was analyzed using STATA 15. Chi-square was used to test bivariate association between categorical variables and adherence. Logistic regression analysis was used to examine sociodemographic, individual and institutional factors influencing adherence to IPTp-SP. Result About 82.1% of participants adhered to the WHO policy recommendations of at least three doses of IPTp-SP. However, only 17.1% received Ghana’s five dose coverage recommendation. The proportion of IPTp-SP coverage for IPTp1 was 98.9%; IPTp2 95.5%; IPTp3 80.8%; IPTp4 39.5%; IPTp5 17.1%. Conclusion Adherence to IPTp-SP was satisfactory according to WHO’s policy recommendation, however, majority of the participants had less than the five doses recommended in Ghana. Number of ANC visits and knowledge of malaria were the main determinants of adherence to IPTp-SP.

scholarly journals Factors influencing adherence to the new intermittent preventive treatment of malaria in pregnancy policy in Keta District of the Volta region, Ghana

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Alren O. Vandy ◽  
Nana Yaw Peprah ◽  
Joseph Yaw Jerela ◽  
Perfect Titiati ◽  
Abubakar Manu ◽  
...  
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
World Health ◽  
Categorical Variables ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Nursing Mothers ◽  
Volta Region ◽  
In Pregnancy

Abstract Background About 25% of pregnant women in malaria-endemic areas are infected with malaria and this accounts for about 15% of maternal deaths globally. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is one of the main strategies for prevention of malaria in pregnancy. A new recommendation was made by the World Health Organization (WHO) that at least three doses of IPTp-SP should be administered before delivery. This study sought to determine the factors influencing adherence to the new IPTp-SP policy in Keta District, Volta region, Ghana. Methods A cross-sectional quantitative study among 375 nursing mothers at four selected health facilities in Keta district, Ghana was conducted using a structured questionnaire to interview participants. Sampling proportionate to the size of facility was used to determine the number of nursing mothers from each facility based on the caseload. For each facility systematic random sampling was used to select eligible nursing mothers. Data was analyzed using STATA 15. Chi-square was used to test bivariate association between categorical variables and adherence. Logistic regression analysis was used to examine sociodemographic, individual and institutional factors influencing adherence to IPTp-SP. Result About 82.1% of participants adhered to the WHO policy recommendations of at least three doses of IPTp-SP. However, only 17.1% received Ghana’s five dose coverage recommendation. The proportion of IPTp-SP coverage for IPTp1 was 98.9%; IPTp2 95.5%; IPTp3 80.8%; IPTp4 39.5%; IPTp5 17.1%. Conclusion Adherence to IPTp-SP was satisfactory according to WHO’s policy recommendation, however, majority of the participants had less than the five doses recommended in Ghana. Number of Antenatal Care (ANC) visits and knowledge of malaria were the main determinants of adherence to IPTp-SP.

scholarly journals Health Workers’ Awareness and Knowledge of Current Recommendation of Intermittent Preventive Treatment in Pregnancy in South-Western Nigeria

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Oluwasomidoyin Olukemi Bello ◽  
Olaolu Oni
Keyword(s):  
Health Workers ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
World Health Organisation ◽  
Malaria In Pregnancy ◽  
World Health ◽  
Current Recommendation ◽  
Cross Sectional ◽  
Correct Knowledge ◽  
In Pregnancy

BACKGROUND: Malaria in pregnancy is of public health significance because of its associated maternal and fetal complications. This study aimed to assess health workers’ awareness and knowledge of the current World Health Organisation (WHO) recommendation of intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine (IPTp-SP).METHODS: A cross-sectional study among 148 health workers who offer obstetrics care in selected health facilities in Ibadan, Nigeria using a self-administered questionnaire to evaluate their awareness and knowledge of the current WHO IPTp-SP. Information on their socio-demographic and professional characteristics, awareness, knowledge and practice of the current IPTp recommendation were obtained. Data analysis involved descriptive and bivariate analyses using SPSS version 20.0 with level of significance set at p<0.05.RESULTS: The majority, 85(57.4%), of the health workers had been providing obstetrics care for less than 5 years with most of them, 114(77.0%), practicing at tertiary health facility. More than half, 92(62.2%), of them were aware of the current WHO IPTp-SP recommendation while about two-fifth (39.1%) had its correct knowledge. Of the health workers who were knowledgeable of the current IPTp-SP recommendation almost three-quarter, 29(72.2%) of them prescribed it. The health workers’ professional cadre (p<0.001) and duration of providing obstetrics care (p=0.012) were significantly associated with their awareness and correct knowledge of the current IPTp-SP recommendation.CONCLUSION: Most of the health workers are aware but not knowledgeable of the correct administration of the current IPTp- SP recommendation. Likewise, many of them do not prescribe it. This calls for regular training and update of health workers and institutional protocol so as to effectively reduce the prevalence of malaria in pregnancy and its complications.

scholarly journals Factors Associated with Uptake of Intermittent Preventive Treatment of Malaria in Pregnancy: A Cross-Sectional Study in Private Health Facilities in Tema Metropolis, Ghana

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Selina Amankwah ◽  
Francis Anto
Keyword(s):  
Antenatal Care ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Health Facilities ◽  
Malaria In Pregnancy ◽  
Second Trimester ◽  
Cross Sectional ◽  
Factors Associated ◽  
Postnatal Women ◽  
In Pregnancy

Introduction. Intermittent preventive treatment of malaria in pregnancy with sulfadoxine pyrimethamine (IPTp-SP) is effective in preventing the adverse consequences of malaria on birth outcomes. Methods. A cross-sectional survey was carried out among antenatal and postnatal women and midwives at private health facilities in Tema using the mixed method to investigate factors associated with uptake of IPTp-SP. Antenatal and postnatal women were consecutively enrolled and data on their sociodemographic characteristics and antenatal service utilization collected using a questionnaire and review of antenatal care (ANC) records. In-depth interviews involving attending midwives were conducted and data on ANC service delivery collected. The interviews were manually analyzed. Bivariate and multiple logistic regression analyses were done to determine factors associated with uptake of SP. Results. Of the 382 respondents, 178 (46.6%) took ≥ 3 doses of SP. Uptake was similar for those who had delivered and those yet to deliver (χ2 =2.94, p > 0.05). Ninety-seven of the 176 (55.1%) women who initiated antenatal visit during the first trimester received ≥ 3 doses of SP whilst 42.0% (76/181) of those who started during the second trimester received ≥ 3 doses (χ2 = 5.64, p = 0.02). Those who initiated ANC during the second trimester received more doses compared to those who started during the third trimester (χ2 = 4.43, p = 0.04). Respondents who attended ANC > 5 times increased their uptake by 83% compared to those who attended < 5 times (OR 0.2, 95% C.I 0.12-0.31). There was poor adherence to directly observed treatment and low knowledge of midwives on IPTp-SP protocol. Conclusion. Early initiation and regular visit to antenatal care centres promoted uptake of optimal doses of SP.

scholarly journals An ethnographic study of how health system, socio-cultural and individual factors influence uptake of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine in a Ghanaian context

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257666
Author(s):  
Matilda Aberese-Ako ◽  
Pascal Magnussen ◽  
Gifty D. Ampofo ◽  
Margaret Gyapong ◽  
Evelyn Ansah ◽  
...  
Keyword(s):  
Health System ◽  
Intermittent Preventive Treatment ◽  
Community Outreach ◽  
Preventive Treatment ◽  
Ethnographic Study ◽  
Health Facilities ◽  
Malaria In Pregnancy ◽  
World Health ◽  
Individual Factors ◽  
In Pregnancy

Background Intermittent preventive treatment of malaria among pregnant women with sulfadoxine-pyrimethamine (IPTp-SP), is one of the three recommended interventions for the prevention of malaria in pregnancy (MiP) in sub-Sahara Africa. The World Health Organisation recommended in 2012 that SP be given at each scheduled ANC visit except during the first trimester and can be given a dose every month until the time of delivery, to ensure that a high proportion of women receive at least three doses of SP during pregnancy. Despite implementation of this policy, Ghana did not attain the target of 100% access to IPTp-SP by 2015. Additionally, negative outcomes of malaria infection in pregnancy are still recurring. This ethnographic study explored how health system, individual and socio-cultural factors influence IPTp-SP uptake in two Ghanaian regions. Methods The study design was ethnographic, employing non-participant observation, case studies and in depth interviews in 8 health facilities and 8 communities, from April 2018 to March 2019, in two Ghanaian regions. Recommended ethical procedures were observed. Results Health system factors such as organization of antenatal care (ANC) services and strategies employed by health workers to administer SP contributed to initial uptake. Women’s trust in the health care system contributed to continued uptake. Inadequate information provided to women accessing ANC, stock-outs and fees charged for ANC services reduced access to IPTp-SP. Socio-cultural factor such as encouragement from social networks influenced utilization of ANC services and IPTp-SP uptake. Individual factors such as refusing to take SP, skipping ANC appointments and initiating ANC attendance late affected uptake. Conclusion Health system, socio-cultural and individual factors influence uptake of optimum doses of IPTp-SP. Consequently, interventions that aim at addressing IPTp-SP uptake should focus on regular and sufficient supply of SP to health facilities, effective implementation of free ANC, provision of appropriate and adequate information to women and community outreach programmes to encourage early and regular ANC visits.

scholarly journals A Cluster Randomized Trial of Delivery of Intermittent Preventive Treatment of Malaria in Pregnancy at the Community Level in Burkina Faso

2020 ◽  
Author(s):  
Julie Gutman ◽  
Daniel K Stephens ◽  
Justin Tiendrebeogo ◽  
Ousmane Badolo ◽  
Mathurin Dodo ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Intermittent Preventive Treatment ◽  
Intervention Group ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
World Health ◽  
Control Group ◽  
P Value ◽  
Cluster Randomized ◽  
In Pregnancy

Abstract Background: Malaria in pregnancy is responsible for 8–14% of low birth weight and 20% of stillbirths in sub-Saharan Africa. To prevent these adverse consequences, the World Health Organization recommends intermittent preventive treatment of pregnant women (IPTp) with sulfadoxine-pyrimethamine be administered at each ANC visit starting as early as possible in the second trimester. Global IPTp coverage in targeted countries remains unacceptably low. Community delivery of IPTp was explored as a means to improve coverage. Methods: A cluster randomized, controlled trial was conducted in 12 health facilities in a 1:1 ratio to either an intervention group (IPTp delivered by CHWs) or a control group (standard practice, with IPTp delivered at HFs) in three districts of Burkina Faso to assess the effect of IPTp administration by community health workers (CHWs) on the coverage of IPTp and antenatal care (ANC). The districts and facilities were purposively selected taking into account malaria epidemiology, IPTp coverage, and the presence of active CHWs. Pre- and post-intervention surveys were carried out in March 2017 and July–August 2018, respectively. A difference in differences (DiD) analysis was conducted to assess the change in coverage of IPTp and ANC over time, accounting for clustering at the health facility level. Results: Altogether 374 and 360 women were included in the baseline and endline surveys, respectively. At baseline, women received a median of 2.1 doses; by endline, women received a median of 1.8 doses in the control group and 2.8 doses in the intervention group (p-value <.0001). There was a non-statistically significant increase in the proportion of women attending four ANC visits in the intervention compared to control group (DiD= 12.6%, p-value= 0.16). By the endline, administration of IPTp was higher in the intervention than control, with a DiD of 17.6% for IPTp3 (95% confidence interval (CI) -16.3, 51.5; p-value 0.31) and 20.0% for IPTp4 (95% CI -7.2, 47.3; p-value= 0.15). Conclusions: Community delivery of IPTp could potentially lead to a greater number of IPTp doses delivered, with no apparent decrease in ANC coverage.

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