scholarly journals Evaluation of the Intermittent Preventive Therapy in Pregnancy using Sulphadoxine/ Pyrimethamine (IPTp-SP) Program in Chiredzi District, Zimbabwe, 2021

2021 ◽  
Author(s):  
Amanda Sarah Thakataka ◽  
Joseph Mberikunashe ◽  
More Mungati ◽  
Tsitsi Patience Juru ◽  
Addmore Chadambuka ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Health Workers ◽  
Intermittent Preventive Treatment ◽  
Outcome Evaluation ◽  
Outcome Variable ◽  
Bivariate Analysis ◽  
Stock Management ◽  
Cross Sectional ◽  
Sulphadoxine Pyrimethamine ◽  
In Pregnancy

Abstract Background Intermittent Preventive Treatment in Pregnancy (IPTp) with Sulphadoxine/ Pyrimethamine (SP) is used for the prevention of malaria among pregnant women in Zimbabwe. The program is integrated into routine Antenatal care (ANC) where a minimum of three doses is recommended during each pregnancy. The third dose coverage for Chiredzi District has consistently been below the 80% target coverage. We evaluated IPTp implementation in Chiredzi to understand the reasons for underperformance. Methods An analytical cross-sectional study was conducted using a Process-Outcome evaluation with the Logical Framework Approach. We interviewed 50 women in postnatal care and determined ANC services accessed using their ANC booklets. Health workers were interviewed for knowledge of the program. Stock availability and drug delivery records were reviewed using checklists at five high-volume sites. Epi Info 7.2.4.0™ was used for data capturing and analysis. The software was used to calculate frequencies, medians, proportions, odds ratios and p-values at a 95% confidence interval. The outcome variable was receiving ≥3 doses of SP which was computed against the independent variables such as client-related characteristics to determine which factors were contributory using univariate and bivariate analysis. Results Only 12/50 (24%) women received ≥3 doses of SP during their pregnancy. Two (4%) women started their ANC visits in the first trimester. Thirty-three (66%) had missed at least one SP dose during their ANC visit because of medicine unavailability. Knowing the number of times SP is given (OR 11.9; 95% CI 2.54-55.8) and having attended at least 4 ANC visits (OR 13.6; 95% CI 1.59 -116.0) increased the likelihood of receiving adequate SP dosing. Conclusions The IPTp-SP program in Chiredzi District was underperforming, we attributed this largely to health system factors. Erratic supply and stock-outs of SP resulted in clients missing SP doses. Clients also missed SP doses because of late ANC booking and lack of knowledge on IPTp benefits. Improving stock management and raising community awareness on prevention of malaria among pregnant women was recommended.

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 Determinants of the Uptake of Intermittent Preventive Treatment of Malaria in Pregnancy with Sulphadoxine Pyrimethamine in Sabatia Sub County, Western Kenya

2021 ◽  
Author(s):  
Joshua Andala Mutanyi ◽  
Daniel O. Onguru ◽  
Sidney O. Ogolla ◽  
Lawrence B. Adipo
Keyword(s):  
Pregnant Women ◽  
Health Workers ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
World Health ◽  
Maternal Knowledge ◽  
Western Kenya ◽  
Sulphadoxine Pyrimethamine ◽  
In Pregnancy

Abstract Background: Malaria in pregnancy remains a major public health problem. Annually, 125.2 million pregnant women worldwide are at risk of malaria infection including 30.3 million and 1 million pregnant women in Sub-Saharan Africa and Kenya respectively. The World Health Organization recommends that pregnant women in malaria endemic areas receive at least three doses of sulphadoxine pyrimethamine for intermittent preventive treatment of malaria in pregnancy (IPTp-SP) for optimal benefit. However, IPTp-SP optimal uptake is undesirably low in Kenya. This study investigated the prevalence of and factors influencing IPTp-SP optimal uptake in Sabatia Sub County, Western Kenya. Understanding the epidemiology of malaria in pregnancy is core for making decisions and setting priorities towards IPTp-SP optimization.Methods: This was a cross-sectional study conducted in Sabatia Sub County. Using a validated semi structured questionnaire, data were obtained from 372 randomly sampled post-delivery women aged 15 – 49 years who had a live birth within one year preceding the study. Women on cotrimoxazole prophylaxis during their pregnancy were excluded. Association between IPTp-SP uptake and independent variables was analysed using Pearson Chi-square and Fisher’s Exact test. Bivariate and multiple binary logistic regression analysed predictors of optimal IPTp-SP uptake.Results: Overall, 99.46 % of the respondents received at least one IPTp-SP dose. The prevalence of optimal IPTp-SP uptake was 79.57% (95% CI 75.47%, 83.67%). After multivariate analysis; gestational age at first antenatal care (ANC) visit (p = 0.04), frequency of ANC visits (p < 0.001), maternal knowledge of IPTp-SP benefits (p < 0.001), maternal knowledge of optimal SP dose (p = 0.03) and administration of sulphadoxine pyrimethamine at ANC clinic (p = 0.03) significantly predicted the optimal uptake of IPTp-SP.Conclusions: Optimal uptake of IPTp-SP is high in the study area. Efforts towards early and more frequent ANC attendance should be enhanced and sustained. Structured and targeted health education should be adopted and health workers should always administer SP drugs or explain to some pregnant women their ineligibility for initial IPTp-SP receipt. Future studies considering large sample drawn from the whole country and health workers’ perspective of the health system delivery factors are recommended.

The Effect of Counselling Intervention during Antenatal Care on the Knowledge and Attitude about Danger Signs in Pregnancy: A Cross-Sectional Study in Takalar Regency -

2020 ◽  
Vol 10 (2) ◽  
pp. 51-55
Author(s):  
Nurhikmah ◽  
Tahir Abdullah ◽  
Stang ◽  
Suriah ◽  
Andi Imam Arundhana ◽  
...  
Keyword(s):  
Health Service ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Community Health ◽  
Health Workers ◽  
Community Health Service ◽  
Cross Sectional ◽  
Danger Signs ◽  
Knowledge And Attitude ◽  
In Pregnancy

Objective: This study was to examine the effects of counselling delivered during antenatal care on the knowledge and attitudes of pregnant women about danger signs in pregnancy.Methods: This was a pre-experimental design using one group pre- and post-test only. This study was conducted in Takalar, specifically within Sanrobone Community Health Service working area. Takalar is located in South Sulawesi Province Indonesia and this area is coastal with the majority of people working as a fisherman. Participants of this study were pregnant women living in the villages which are included in the working area of Sanrobone Community Health Service.Results: The study shows that counselling improved knowledge and attitude of pregnant women about danger signs in pregnancy (p=0.011 and p=0.025, respectively). The number of pregnant women with good knowledge and positive attitude increased after the intervention (43.8% vs 93.8%, 62.5% vs 93.8%, respectively).Conclusions: In can be concluded that intervention by means of counselling can improve the knowledge and attitude of pregnant women about danger signs in pregnancy. Therefore, it is important to implement the counselling program delivered by health workers in Community Health Service in order to mitigate the risk of maternal mortality.

scholarly journals FAKTOR- FAKTOR YANG MEMPENGARUHI KEJADIAN ANEMIA PADA IBU HAMIL

2021 ◽  
Vol 7 (3) ◽  
pp. 404-412
Author(s):  
Dian Zuiatna
Keyword(s):  
Nutritional Status ◽  
Pregnant Women ◽  
Health Center ◽  
Health Workers ◽  
B Value ◽  
Dominant Factor ◽  
Survey Method ◽  
P Value ◽  
Cross Sectional ◽  
In Pregnancy

Introduction: Anemia is a problem in pregnancy because in pregnancy need for nutrients increases and changes in the blood and bone marrow occur. According to WHO, 40% of mortality maternal in developing countries is related to anemia in pregnancy.Objective: to determine the factors that influence anemia in pregnant women at Batu Gana Health Center in 2020.Methode: This research used an analytic survey method with a cross-sectional approach. The population was 115 people who came to check their pregnancies at the Batugana Health Center. The sample taken by using purposive sampling amounted to 53 respondents. Data analysis used the chi-square test.Results: showed that there was a correlation between knowledge about the incidence of anemia with a p-value of.040 (<.05), there was a relationship between nutritional status and the incidence of anemia with a p-value of 0.000 (<.05), there was a relationship between compliance with iron consumption and the incidence. Anemia with a p-value of .002 (<.05) and the most dominant factor affecting the incidence of anemia was nutritional status with an Exp (B) value of 30.400, meaning that family support was 30 times more likely to affect the incidence of anemia in pregnant women.Conclusion: showed that there is an effect of knowledge, nutritional status, adherence to iron consumption on the incidence of anemia.Suggestions are expected to health workers, especially midwives and doctors to improve health services, especially pregnant women so that the health status of pregnant women can be improved so that the incidence of anemia can be avoided.  Keywords: Anemia Incidence, Knowledge, Nutritional Status, Compliance with Iron Consumption ABSTRAK Latar Belakang: Anemia merupakan masalah pada wanita di dunia termasuk Indonesia. Anemia lebih sering dijumpai dalam kehamilan karena dalam kehamilan kebutuhan akan zat-zat makanan bertambah dan terjadi perubahan-perubahan dalam darah dan sumsum tulang. Menurut WHO 40% kematian ibu di negara berkembang berkaitan dengan anemia dalam kehamilan.Tujuan: untuk mengetahui faktor-faktor yang mempengaruhi kejadian anemia pada ibu hamil di Puskesmas Batu Gana Tahun 2020.Metode: Jenis penelitian menggunakan metode survey analitik dengan pendekatan cross-sectional. Populasi adalah seluruh ibu hamil yang datang memeriksakan kehamilannya di Puskesmas Batugana yaitu sebanyak 115 orang dengan teknik pengambilan sampel yaitu purrposive sampel dengan menggunakan rumus slovin dan diperoleh jumlah sampel 53 responden. Analisis data dengan menggunakan uji chi square.Hasil:  penelitian menunjukkan ada hubungan pengetahuan terhadap kejadian anemia dengan nilai p-value 0,040 (<0,05), ada hubungan status gizi terhadap kejadian anemia dengan nilai p-value 0,000 (<0,05), ada hubungan kepatuhan konsumsi zat besi terhadap kejadian anemia dengan nilai p-value 0,002 (<0,05) dan factor yang paling dominan mempengaruhi kejadian anemia adalah status gizi dengan nilai Exp (B) 30.400 artinya dukungan keluarga 30 kali lebih cenderung mempengaruhi kejadian anemia pada ibu hamil.Kesimpulan: ada pengaruh pengetahuan, status gizi, kepatuhan konsumsi zat besi terhadap kejadian anemia.Saran diharapkan kepada petugas kesehatan khusunya Bidan dan Dokter untuk meningkatkan pelayanan kesehatan khususnya ibu hamil agar status kesehatan ibu hamil dapat  ditingkatkan sehingga kejadian anemia dapat dihindari.  Kata Kunci: Kejadian Anemia, Pengetahuan, Status Gizi, Kepatuhan Konsumsi Zat Besi

scholarly journals Factors Associated with Anemia in Pregnancy in Cascades Region in Burkina Faso

2015 ◽  
pp. 663-664
Author(s):  
Ilboudo Bernard ◽  
Savadogo G. Léon Blaise ◽  
Kinda Maurice ◽  
Guiguemde T. Robert ◽  
Dramaix-wilmet Michèle ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Anemia In Pregnancy ◽  
Prevalence Of Anemia ◽  
In Pregnancy

Objectives: To analyze the factors associated with anemia in pregnancy in the Cascades region in Burkina Faso. Methods: A cross-sectional study was carried out in antenatal clinics of the Cascades region in Burkina Faso during one month from May to June 2012. We collected data on socio-demographics and health characteristics of pregnant women attending these clinics. Hemoglobin was measured to assess anemia. Factors associated with anemia were identified through a multivariate analysis. Results: A total of 1763 pregnant women, irrespectively of pregnancy stage, were enrolled. The mean (SD) hemoglobin level was 10.6 (1.4) g/dl. The prevalence of anemia in pregnancy was 58.9%, 3.2% of them being severe. Factors associated with anemia were the absence of intermittent preventive treatment of malaria with sulfadoxin-pyrimetamin (OR = 1.3, 95% CI: 1.0-1.7), number of pregnancies >6 (OR = 1.4, 95% CI: 1.1-1.9). Moderate consumption of local alcohol extracted from Palmyra was associated with a lower prevalence of anemia (OR = 0.7, 95% CI: 0.5-0.9). Surprisingly, anemia was not associated with supplementation with folic acid + iron (p = 0.60). Conclusions: Interventions which aim to reduce the prevalence of anemia in pregnancy in Burkina Faso should improve the coverage of the intermittent preventive treatment of malaria and support the limitation of births.

scholarly journals PO 8502 DETERMINANTS AND PREVALENCE OF PARASITE RESISTANCE AMONG PREGNANT WOMEN RECEIVING IPTP WITH SULPHADOXINE-PYRIMETHAMINE IN NIGERIA

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A46.3-A47
Author(s):  
Atinuke Olaleye ◽  
Noblefather Uyaiabasi ◽  
Charles Elikwu ◽  
Oladapo Walker
Keyword(s):  
Pregnant Women ◽  
Geometric Mean ◽  
Intermittent Preventive Treatment ◽  
Epidemiological Surveillance ◽  
Eligibility Criteria ◽  
Resistance Level ◽  
Gene Markers ◽  
Maternal Characteristics ◽  
Sulphadoxine Pyrimethamine ◽  
In Pregnancy

BackgroundMalaria in pregnancy carries a risk of significant adverse maternal and infant outcomes. Intermittent preventive treatment in pregnancy (IPTp) is advocated to reduce its occurrence, but resistance to sulphadoxine-pyrimethamine (SP) is being reported. This study aims to describe the burden of SP resistance and determinants of its occurrence among pregnant women receiving IPTp in Nigeria.MethodsA prospective observational study is to be conducted in Ogun State over 24 months. Pregnant women 16–28 weeks gestation meeting the eligibility criteria are being enrolled; blood samples are taken for analysis pre- and post- IPTp-SP administration at scheduled intervals. Microscopy-confirmed parasitaemic samples will be analysed using PCR to detect drug resistance markers (pfdhfr and pfdhps). Participants will be followed up until 28 days post-delivery and assessed for maternal and foetal outcomes (anaemia, low birth weight, preterm delivery, placental parasitaemia, stillbirth, neonatal death). The primary endpoint is the prevalence of the SP resistance gene markers. Secondary endpoints include the prevalence of peripheral and placental parasitaemia at delivery; incidence of maternal and newborn morbidity; parasitaemia pre-IPTp and day 28 post-IPTp; risk factors for SP resistance and haemoglobin changes at delivery.ResultsFollowing statistical analysis with STATA 14, results will be displayed in appropriate formats. Geometric mean parasite densities with 95% confidence intervals will be calculated, and proportions compared using the t-test, Chi-square or Fisher’s exact tests as appropriate. Multivariate analysis including logistic regression models will be used to test for associations between maternal characteristics and SP resistance. Level of significance will be set at p<0.05.ConclusionIn a malaria-endemic country like Nigeria with a large at-risk population, information on the effectiveness of chemoprevention is essential. Determining the proportion and extent of relevant molecular markers within the population offers an invaluable tool for epidemiological surveillance of SP resistance within this endemic setting.

scholarly journals Malaria Knowledge and Experiences with Community Health Workers among Recently Pregnant Women in Malawi

2019 ◽  
Author(s):  
Ashley Malpass ◽  
Jobiba Chinkhumba ◽  
Elizabeth Davlantes ◽  
John Munthali ◽  
Katherine Wright ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
World Health ◽  
P Value ◽  
To Receive ◽  
In Pregnancy

Abstract Background The World Health Organization (WHO) recommends three or more doses of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) to mitigate the negative effects of malaria in pregnancy (MIP). Many pregnant women in Malawi are not receiving the recommended number of doses. Community delivery of IPTp (cIPTp) is being piloted as a new approach to increase coverage. This survey assessed recently pregnant women’s knowledge of MIP and their experiences with community health workers (CHWs) prior to implementing cIPTp.Methods Data were collected via a household survey in Ntcheu and Nkhata Bay Districts, Malawi, from women aged 16-49 years who had a pregnancy resulting in a live birth in the previous 12 months. Survey questions were primarily open response and utilized review of the woman’s health passport whenever possible. Analyses accounted for selection weighting and clustering at the health facility level and explored heterogeneity between districts.Results A total of 370 women were interviewed. Women in both districts found their CHWs to be helpful (77.9%), but only 35.7% spoke with a CHW about antenatal care and 25.8% received assistance for malaria during their most recent pregnancy. A greater proportion of women in Nkhata Bay than Ntcheu reported receiving assistance with malaria from a CHW (42.7% vs 21.9%, p=0.01); women in Nkhata Bay were more likely to cite IPTp-SP as a way to prevent MIP (41.0% vs 24.8%, p=0.02) and were more likely to cite mosquito bites as the only way to spread malaria (70.6% vs 62.0% p=.03). Women in Nkhata Bay were more likely to receive 3+ doses of IPTp-SP (IPTp3) (59.2% vs 41.8%, p=0.0002). Adequate knowledge was associated with increased odds of receiving IPTp3, although not statistically significantly so (adjusted odds ratio = 1.50, 95% confidence interval 0.97- 2.32, p-value 0.066).Conclusions Women reported positive experiences with CHWs, but there was not a focus on MIP. Women in Nkhata Bay were more likely to be assisted by a CHW, had better knowledge, and were more likely to receive IPTp3+. Increasing CHW focus on the dangers of MIP and implementing cIPTp has the potential to increase IPTp coverage. Keywords: Malaria Pregnancy Community Health Workers Malawi Intermittent preventive treatment Sulfadoxine-pyrimethamine

scholarly journals Keberhasilan Pelaksanaan Senam Hamil terhadap Proses Persalinan

2021 ◽  
Vol 16 (1) ◽  
pp. 191-194
Author(s):  
Vitri yuli afni Amran
Keyword(s):  
Pregnant Women ◽  
Success Rate ◽  
Health Workers ◽  
Preventive Measure ◽  
Simple Random Sampling ◽  
Total Sample ◽  
Bivariate Analysis ◽  
Chi Square ◽  
Cross Sectional ◽  
Pregnancy And Childbirth

The American College of Obstetricians and Gynecologists (ACOG) recommends exercise as a preventive measure for mothers so that the process of pregnancy and childbirth runs naturally and reduces the crisis caused by childbirth. This study aims to determine the analysis of the success rate of the implementation of pregnant exercise on the delivery process at the Puskesmas Lubuk Buaya Padang in 2018. This type of research is an analytical study with a cross-sectional approach that has been carried out in the Work Area of ??the Lubuk Buaya Puskesmas in Padang in October 2017 - June. 2018. The population of all mothers who have experienced childbirth in the Lubuk Buaya Padang Public Health Center is 2,042 people. Samples were taken by simple random sampling with a total sample of 48 people. Data collection using a questionnaire. Then the data were analyzed by univariate and bivariate with the chi-square statistical test. The results showed that 31.3% of mothers did not carry out pregnancy exercise correctly. As much as 37.5% of mothers gave birth with action and based on bivariate analysis there was a significant relationship between the success rate of implementing pregnancy exercise and the delivery process (p = 0.000). The results of the study, it can be concluded that there is a relationship between the success rate of implementing pregnancy exercise with the delivery process, it is hoped that health workers will continue to provide health education and counseling and disseminate information about pregnancy exercise and empower other health workers to conduct pregnancy exercise counseling for pregnant women. how to demonstrate every pregnancy exercise movement in various pregnancy class activities so that mothers can understand it. Key words: pregnancy exercise, childbirth process, class of pregnant women

scholarly journals Malaria knowledge and experiences with community health workers among recently pregnant women in Malawi

2020 ◽  
Author(s):  
Ashley Malpass ◽  
Jobiba Chinkhumba ◽  
Elizabeth Davlantes ◽  
John Munthali ◽  
Katherine Wright ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
World Health ◽  
P Value ◽  
To Receive ◽  
In Pregnancy

Abstract Background The World Health Organization recommends three or more doses of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) to mitigate the negative effects of malaria in pregnancy (MIP). Many pregnant women in Malawi are not receiving the recommended number of doses. Community delivery of IPTp (cIPTp) is being piloted as a new approach to increase coverage. This survey assessed recently pregnant women’s knowledge of MIP and their experiences with community health workers (CHWs) prior to implementing cIPTp. Methods Data were collected via a household survey in Ntcheu and Nkhata Bay Districts, Malawi, from women aged 16-49 years who had a pregnancy resulting in a live birth in the previous 12 months. Survey questions were primarily open response and utilized review of the woman’s health passport whenever possible. Analyses accounted for selection weighting and clustering at the health facility level and explored heterogeneity between districts.Results A total of 370 women were interviewed. Women in both districts found their CHWs to be helpful (77.9%), but only 35.7% spoke with a CHW about antenatal care and 25.8% received assistance for malaria during their most recent pregnancy. A greater proportion of women in Nkhata Bay than Ntcheu reported receiving assistance with malaria from a CHW (42.7% vs 21.9%, p=0.01); women in Nkhata Bay were more likely to cite IPTp-SP as a way to prevent MIP (41.0% vs 24.8%, p=0.02) and were more likely to cite mosquito bites as the only way to spread malaria (70.6% vs 62.0% p=.03). Women in Nkhata Bay were more likely to receive 3+ doses of IPTp-SP (IPTp3) (59.2% vs 41.8%, p=0.0002). Adequate knowledge was associated with increased odds of receiving IPTp3, although not statistically significantly so (adjusted odds ratio = 1.50, 95% confidence interval 0.97- 2.32, p-value 0.066). Conclusions Women reported positive experiences with CHWs, but there was not a focus on MIP. Women in Nkhata Bay were more likely to be assisted by a CHW, had better knowledge, and were more likely to receive IPTp3+. Increasing CHW focus on the dangers of MIP and implementing cIPTp has the potential to increase IPTp coverage.

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