Barriers to effective uptake of malaria prevention interventions in Ibadan, South West Nigeria: a qualitative study

Abstract

Background: Although control measures have achieved considerable success, malaria is still a major public health problem in Nigeria and sub-Saharan Africa. The malaria burden is more among vulnerable groups like pregnant women and under-five aged children. This study explored barriers affecting uptake of current malaria prevention interventions in Ibadan, Southwest Nigeria.Methods: The study was conducted using qualitative research methods between May and August 2016 among community residents in Ibadan, Oyo state-Nigeria. Six focus group discussions (FGDs) and 16 in-depth interviews (IDI) were conducted with community members who were purposively selected and consented to participate in the study. The participants were grouped into six homogenous focus groups which included; pregnant women, mothers of under-five children, husbands, fathers, civil society members, and health staff such as hospital manager, nurses, pharmacist, medicine vendors, doctors, state program staff and national program staff. Data were transcribed, manually coded and analysed using content and thematic method. The Biomedical Research Ethics Committee (BREC), University of KwaZulu-Natal, South Africa and Oyo state Ministry of Health Ethics Committee, Nigeria both approved the study.Results: Knowledge on malaria causality and symptoms, prevention strategies, beliefs, fear of side effects from current malaria preventive measures, corruption and difficulty in obtaining nets, and poor environmental hygiene were some of the themes which emerged as barriers to the effective uptake of malaria prevention intervention.Conclusions: Strategies at the community level are urgently needed to address and improve within socio-cultural context uptake of current malaria prevention interventions.

Knowledge of malaria prevention among pregnant women and non-pregnant mothers of children aged under 5 years in Ibadan, South West Nigeria

“…1 ). The study setting and site have been described in another publication [ 16 ]. The hospital is situated in the semi-urban community of Yemetu-Adeoyo in Ibadan.…”

A Socio-Ecological Approach To Understanding The Factors Influencing The Uptake Of Intermittent Preventive Treatment Of Malaria In Pregnancy (IPTp) In South Western Nigeria.

“…While nancial and geographical barriers to ANC services in public health facilities cut across the individual and social levels, their impact on access to ITNs and IPTp remain prevalent as shown in this and other studies (6,15,16). Costs associated with procurement of SP and ITNs when they are out of stock at public health facilities directly affect pregnant women's access to IPTp and ITNs.…”

“…The Nigerian Demographic and Health Survey 2018 (NDHS) shows that 58% of pregnant women had slept under an ITN the preceding night and while about 57% of women attended four or more ANC visits, only 17% of women with a live birth in the last two years had received at least three IPTp doses (5). A few studies have shown some health system and individual factors (4,6) as key contributors to the low uptake of ITN and IPTp in Nigeria. However, there is scant evidence on how interpersonal, societal and provider related factors contribute to the poor uptake of ITNs and IPTp, particularly in rural and lower socioeconomic communities where social and communal norms are most in uential.…”

A socio-ecological approach to understanding the factors influencing the uptake of intermittent preventive treatment of malaria in pregnancy (IPTp) in South-Western Nigeria

“…While this provides an opportunity to further enhance the acceptability and uptake of IPTp among attending pregnant women, this healthseeking behaviour could further be harnessed by building the capacities of health care provider alternatives regarding MiP and the value of IPTp. While financial and geographical barriers to ANC services in public health facilities cut across the individual and social levels, their impact on access to ITNs and IPTp remain prevalent as shown in this and other studies [6,17,18]. Costs associated with procurement of SP and ITNs when they are out of stock at public health facilities directly affect pregnant women's access to IPTp and ITNs.…”

“…The Nigerian Demographic and Health Survey 2018 (NDHS) shows that 58% of pregnant women had slept under an ITN the preceding night and while about 57% of women attended four or more ANC visits, only 17% of women with a live birth in the last two years had received at least three IPTp doses [ 5 ]. A few studies have shown some health system and individual factors [ 4 , 6 ] as key contributors to the low uptake of ITN and IPTp in Nigeria. However, there is scant evidence on how interpersonal, societal and provider related factors contribute to the poor uptake of ITNs and IPTp, particularly in rural and lower socio-economic communities where social and communal norms are most influential.…”