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

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

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

10.21203/rs.3.rs-33995/v1 ◽

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.

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

10.21203/rs.3.rs-28732/v1 ◽

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.

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

BMC Infectious Diseases ◽

10.1186/s12879-021-06135-2 ◽

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.

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

10.21203/rs.3.rs-33995/v2 ◽

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.

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

BMC Public Health ◽

10.1186/s12889-020-09967-w ◽

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.

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