BackgroundThe objective of this study is to explore and document perceptions and attitude associated with uptake of interventions to prevent malaria in pregnancy infection during pregnancy in Enugu State, Nigeria.MethodsThis is a cross-sectional study in three local government areas in Enugu State to identify the people’s perceptions and attitudes towards sleeping under insecticide-treated bednets and uptake of recommended doses of intermittent presumptive treatment during pregnancy. In-depth interview guides were employed to collect data from health workers and mothers who delivered within 6 months preceding the study, while focus group discussion guides were employed in collecting data from grandmothers and fathers of children born within 6 months preceding the study.ResultsThe people expressed fairly good knowledge of malaria, having lived in the malaria-endemic communities. However, some were ignorant on what should be done to prevent malaria in pregnancy. Those who were aware of the use of insecticide-treated bednets and intermittent presumptive treatment during pregnancy however lamented the attitude of the health workers, who make access to these interventions difficult.ConclusionsEfforts to prevent malaria in pregnancy should focus on providing health education to pregnant women and their partners, who reinforce what the women are told during antenatal care. The attitude of health workers towards patients, who need these interventions, should be targeted for change.

To identify key socio-demographic and knowledge factors associated with compliance with recommended use of commodities for preventing malaria in pregnancy (MIP) in Enugu State, Nigeria. Cross-sectional study of 720 women who delivered within 6 months preceding the survey in three local government areas in Enugu State was conducted using a structured questionnaire. About half (51.6%) of the women used IPTp1 while 25.9% took IPTp2 as recommended during their most recent pregnancy. Forty-one percent of the women slept under insecticide treat nets (ITN) during the most recent pregnancy but only 15.4% did so as recommended every night. Socio-demographic and knowledge factors associated with compliance were identified. Compliance with intermittent presumptive treatment in pregnancy (IPTp) recommendation was more common among those in the rural setting (26.9%) compared to the peri-urban (20.3%) and urban (17.3%) (P = 0.032). Those with good knowledge of the causes, effects and prevention of malaria during pregnancy complied more (23.7%) than those with poor knowledge (17.0%) (P = 0.020). With respect to sleeping under ITN, more of those with post secondary education, good knowledge of MIP and currently living with a partner used ITN every night during the last pregnancy. Knowledge about the MIP issues and having a partner influence compliance with relevant preventives. Efforts to increase compliance with recommended practices to prevent MIP should focus on providing health education to pregnant women and their partners, who reinforce what the women are told during antenatal care. More qualitative studies need to be conducted on this subject.

Background Uptake of iron–folate supplementation for at least 90 days during pregnancy is recommended as a cost-effective way of reducing iron deficiency anemia, the commonest form of anemia among women of childbearing ages. The paper examines the level of compliance in Nigeria. Methods We analysed a sample of 14 740 married women aged 15–49 years from the 2018 Nigerian Demographic and Health Survey with available data on hemoglobin and anemia. Multinomial logistic regression models were used to establish associations between socio-demographic characteristics, compliance with recommended uptake of micronutrients and anemia status of the mothers. Results A number of socio-demographic factors, namely maternal age, type of residence, education, wealth, among others correlated with incidence of maternal anemia as well as compliance with recommended uptake of micronutrient to protect against anemia. For instance, whereas 46.3% of mothers from rural backgrounds were not anemic, 39.0% of those with urban background were not anemic (P < 0.001). More than half (56.2%) of mothers in the richest households were anemic compared with about a third (34.6%) of mothers in the poorest household who were not anemic (P < 0.001). The urban dwellers, richer and more educated mothers complied more with the uptake of iron–folate supplements to protect against anemia during pregnancy (P < 0.001). The younger mothers (15–29 years) were more likely to comply with iron intake (odds ratio: 1.150 (1.060–1.247)).

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