Factors influencing utilization of intermittent preventive treatment for pregnancy in the Gushegu district, Ghana, 2013

Abstract

IntroductionThe coverage of adequate (≥2 doses) IPTp-SP in Ghana is below the national target of 80% and that is a threat to reducing the incidence of malaria in pregnancy. The primary objective of the study was to determine the client and facility related factors associated with adequate uptake of IPTp-SP and suggest approaches for increased uptake.MethodsA cross sectional study was conducted among ANC clients and staff in Gushegu, questionnaires was administered to 330 conveniently sampled nursing mothers and all ANC staff present. A checklist and observation were used to collect health facility data. Data was analyzed descriptively and associations between the related factors and adequate uptake of IPTp-SP were determined.ResultsA total of 91.5% and 8.5% of respondents took adequate (≥2doses) and inadequate (≤1dose) IPTp-SP respectively. 85.4% respondents were early first ANC attendance and 80% were multiple gravidae. Mean ANC visits was 5.0 (standard deviation = 2.2). The key determinants for inadequate uptake of IPTp were Unemployment [OR= 4.9 95% CI (1.9-13.1], single gravidae [OR= 3.4 95% CI (1.5-7.6)] and late first ANC visit [OR= 6.8 95% CI (3.0-15.4)]. DOT practice, good staff attitude and health talk at the facility were observed and confirmed by ANC clients as satisfactory. adequate uptake of SP among respondents was high. Majorities were unemployed, have had multiple pregnancies and made early first ANC visits. Unemployment and late first ANC visits are significantly associated with taking inadequate SP dose.ConclusionAdequate uptake of SP among respondents was high. Majorities were unemployed, have had multiple pregnancies and made early first ANC visits. Unemployment and late first ANC visits are significantly associated with taking inadequate SP dose.

Association between timing and number of antenatal care visits on uptake of intermittent preventive treatment for malaria during pregnancy among Malawian women

“…Compared with other studies [ 23 , 25 , 26 , 33 , 38 ], this study further demonstrated the independent association between timing of the first ANC visit, in addition to the number of ANC visits, and IPTp uptake among pregnant women. In particular, the results suggest that reporting for the first ANC earlier during pregnancy, despite having an inadequate number of ANC visits, was associated with recommended IPTp uptake.…”

“…Increased odds of recommended IPTp uptake in those with adequate visits despite having late initiation of ANC were also observed, but with a wider confidence interval, possibly because of the smaller sample number in this category. Two Ghanaian studies reported that 4 or more ANC visits were associated with higher IPTp uptake [ 26 , 33 ]. The current findings further revealed the significance of this factor, independent of the timing of the first ANC visit, suggesting the need for healthcare workers to encourage late ANC initiators to make frequent ANC visits.…”

“…Studies have reported age and marital status [ 23 , 49 ], wealth [ 24 , 30 ], education [ 23 , 24 , 30 ], and parity [ 23 , 26 , 30 ] to be significant predictors for IPTp uptake. However, this study did not observe a significant association between socio-demographics and IPTp uptake.…”

“…Although several studies have examined the effects of ANC attendance on IPTp uptake, the association has been inconsistent [ 26 , 29 – 33 ]. For example, a Kenyan study found an association between the timing of first ANC visit and uptake of IPTp [ 29 ], whereas studies in Uganda, Tanzania, and Nigeria have reported no such association [ 34 – 37 ].…”

Building Global Epidemiology and Response Capacity with Field Epidemiology Training Programs

“…FETPs play critical roles in addressing priority public health problems in countries, often with the collaboration and support of international initiatives such as the US President’s Emergency Plan for AIDS Relief ( 37 , 38 ), the President’s Malaria Initiative ( 39 , 40 ), and the Global Polio Eradication Initiative ( 41 , 42 ). This approach ensures that residents’ work supports national and global priorities while the residents practice applying epidemiologic methods to these programs and providing public health service.…”