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

Muhammad, Fatima; Majdzadeh, Reza; Sajadi, Haniye Sadat; Parsaeian, Mahboubeh

doi:10.1186/s12889-020-09967-w

Cited by 10 publications

(17 citation statements)

References 25 publications

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“…The study found that the realised usage of optimal doses of IPTp among women with recent deliveries in Nigeria is low (21.8%). This is consistent with evidence provided in government reports [7] and several hospital or population-based studies [25,9,11,20,13]. However, the observed prevalence deviates widely from ndings in few other studies [18,23,22,19,14].…”

Section: Discussionsupporting

confidence: 91%

“…This is important because low coverage re ects missed opportunities not only to deliver IPTp to pregnant women [16] but also missed opportunities to reduce adverse maternal and child health outcomes [17] in the country. Studies in Nigeria [18][19][20]12] and elsewhere in sub-Saharan Africa [13][14] have explored the factors in uencing use of IPTp with many of the studies identifying some important determinants of IPTp usage across sub-Saharan Africa. The identi ed determinants among others include type of antenatal care facility, health insurance enrolment, number of antenatal care visits [21], education, parity [22], timing of rst antenatal visit [23], employment [24], place of residence [25], geographical region [13], knowledge of malaria preventive strategies [26], maternal age, and household wealth index [27][28].…”

Section: Introductionmentioning

confidence: 99%

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Using Andersen’s Behavioural Model of Health Services use to Examine usage of Intermittent Preventive Treatment of Malaria in Pregnancy in Nigeria

Solanke¹,

Adebayo²,

Oyeleye³

et al. 2021

Preprint

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Background: Studies in Nigeria and elsewhere in sub-Saharan Africa have explored factors influencing usage of intermittent preventive treatment of malaria in pregnancy (IPTp). However, most of the studies are not model or theory-based, which provides less satisfactory guidance to malaria control programming. This study fills the knowledge gap by adapting the Andersen’s behavioural model of health services use to IPTp usage in Nigeria.Methods: This study adopted a cross-sectional design that utilised secondary data extracted from the 2018 Nigeria Demographic and Health Survey (NDHS). A weighted sample of 4,772 women who had deliveries in the past year preceding the survey was analysed. The outcome variable was usage of IPTp dichotomised into optimal or otherwise. The explanatory variables cut across individual and community levels, and were divided into predisposing, enabling and need factors in line with the theoretical constructs of the Andersen model. Two multilevel mixed-effects logistic regression models were fitted to identify the factors influencing optimal usage of IPTp. Analyses were performed using Stata 14. Statistical significance was set at 5%. Results: The realised level of optimal IPTp usage was 21.8%. The factors that either predispose or enables a pregnant woman to take optimal doses of IPTp are age, education, being employed, being autonomous on own healthcare, health insurance enrolment, partner education, receiving antenatal care in public health facility, rural residence, being resident in northern geo-political zones, community literacy level, and community perception of the consequences of malaria. Two significant need factors affecting optimal usage of IPTp are timing of first antenatal care contact and actual sleeping under mosquito bed net. Conclusion: Optimal usage of IPTp is low among pregnant women in Nigeria. There is need to devise additional public health education programme promoting IPTp usage through the formation of Advocacy, Communication and Social Mobilisation (ACSM) core group in every ward in all the local government areas in the country. In addition, health planners in the country should adopt the use of the Andersen model for assessing key determinants of IPTp usage among childbearing women in the country.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Using Andersen’s Behavioural Model of Health Services use to Examine usage of Intermittent Preventive Treatment of Malaria in Pregnancy in Nigeria

Solanke¹,

Adebayo²,

Oyeleye³

et al. 2021

Preprint

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“…However, this current study found that pregnant women have reduced odds of receiving the optimal doses of IPTp-SP regardless of their wealth index. Conversely, Muhammed et al, 2020 found that pregnant women from the wealthiest households have increased IPTp-SP uptake than those from the poorest households in Nigeria (11). The disparity in the results may be attributed to the different methodologies adopted in assessing the association between wealth index and uptake of IPTp-SP.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have reported that pregnant women’s attitudes and motivation to receive IPTp-SP was related to their levels of knowledge of malaria-related factors such as morbidities caused by malaria (8, 9). Similarly, region, religion, age, and marital status influenced the number IPTp-SP doses received during pregnancy (8,10,11). Socioeconomic considerations including education level, spouse’s education level, employment status, health insurance coverage and household wealth index influenced IPTp-SP uptake (12, 13).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with the uptake of Intermittent Preventive Treatment (IPTp-SP) for malaria in pregnancy: further analysis of the 2018 Nigeria Demographic and Health Survey

Kalu

Francis

Ibisomi

et al. 2022

Preprint

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Pregnancy-associated malaria is preventable and curable with intermittent preventive treatment with Sulfodoxine-Pyrimethamine (IPTp-SP). However, despite the effectiveness of IPTp-SP against malaria in pregnancy, the uptake among pregnant women in Nigeria remains very low. Thus, this study aimed to establish the factors associated with the uptake of at least one dose and optimal doses of IPTp-SP among pregnant women aged 15 to 49 years living in Nigeria in 2018. The study included 12,742 women aged 15 to 49 years with live births two years before or during the 2018 Nigeria Demographic Health Survey (NDHS) in the analysis. Descriptive analysis was carried out to determine the prevalence of IPTp-SP uptake. Multivariable logistic regression was used to establish the factors associated with receiving IPTp-SP during pregnancy, adjusting for possible confounding factors. Given the complex survey design, all analyses adjusted for sampling weight, stratification and clustering. The p-value of <0.05 was considered significant. In 2018, the prevalence of at least one dose of IPTp-SP was 63.6% (95% CI:62.0–65.1), and optimal doses of IPTp-SP were 16.8% (95% CI:15.8–17.8) during pregnancy. After the multivariable analysis, age group, region, frequency of ANC visits, belief in IPTp-SP effectiveness, and morbidity caused by malaria predicted the uptake of at least one IPTp-SP dose. Similar maternal characteristics, including household wealth index, spouse’s educational level and media exposure, were significantly associated with taking optimal IPTp-SP doses. For instance, women in the wealthiest households whose husbands had secondary education predicted a four-fold increase in uptake of at least one IPTp-SP dose (aOR:4.17; 95% CI:1.11–8.85). The low prevalence and regional variations of IPTp-SP uptake in the study area imply that most pregnant women in Nigeria are at substantial risk of pregnancy-associated malaria. Therefore, stakeholders should explore context-specific strategies to improve the IPTp-SP coverage across the regions in Nigeria.

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“…One of these recommendations is to protect pregnant women with SP antimalarial drug in regions where there are moderate and high transmission of malaria [11]. In Nigeria, only 26.2% of pregnant women took three doses or more of IPTp as recommended by the WHO [12].…”

Section: Introductionmentioning

confidence: 99%

Geopolitical zones differentials in intermittent preventive treatment in pregnancy (IPTp) and long lasting insecticidal nets (LLIN) utilization in Nigeria

Chukwu¹,

Onuoha

Okorafor

et al. 2021

PLoS ONE

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Background The coverage of long lasting insecticidal nets (LLIN) and intermittent preventive treatment of malaria in pregnancy (IPTp) uptake for the prevention of malaria commonly vary by geography. Many sub-Saharan Africa (SSA) countries, including Nigeria are adopting the use of LLIN and IPTp to fight malaria. Albeit, the coverage of these interventions to prevent malaria across geographical divisions have been understudied in many countries. In this study, we aimed to explore the differentials in LLIN and IPTp uptake across Nigerian geopolitical zones. Methods We analyzed data from Nigeria Multiple Indicator Cluster Survey (MICS) 2016–17. The outcome variables were IPTp and LLIN uptake among women of childbearing age (15–49 years). A total sample of 24,344 women who had given birth were examined for IPTp use and 36,176 women for LLIN use. Percentages, Chi-square test and multivariable logit models plots were used to examine the geopolitical zones differentials in IPTp and LLIN utilization. Data was analyzed at 5% level of significance. Results The overall prevalence of IPTp was 76.0% in Nigeria. Moreover, there were differences across geopolitical zones: North Central (71.3%), North East (76.9%), North West (78.2%), South East (76.1%), South South (79.7%) and South West (72.4%) respectively. Furthermore, the prevalence of LLIN was 87.7%% in Nigeria. Also, there were differences across geopolitical zones: North Central (89.1%), North East (91.8%), North West (90.0%), South East (77.3%), South South (81.1%) and South West (69.8%) respectively. Women who have access to media use, married, educated and non-poor were more likely to uptake IPTp. On the other hand, rural dwellers and those with media use were more likely to use LLIN. Conversely, married, educated, non-poor and women aged 25–34 and 35+ were less likely to use LLIN. Conclusion Though the utilization of IPTp and LLIN was relatively high, full coverage are yet to be achieved. There was geopolitical zones differentials in the prevalence of IPTp and LLIN in Nigeria. Promoting the utilization of IPTp and LLINs across the six geopolitical zones through intensive health education and widespread mass media campaigns will help to achieve the full scale IPTp and LLIN utilization.

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

Cited by 10 publications

References 25 publications

Using Andersen’s Behavioural Model of Health Services use to Examine usage of Intermittent Preventive Treatment of Malaria in Pregnancy in Nigeria

Using Andersen’s Behavioural Model of Health Services use to Examine usage of Intermittent Preventive Treatment of Malaria in Pregnancy in Nigeria

Factors associated with the uptake of Intermittent Preventive Treatment (IPTp-SP) for malaria in pregnancy: further analysis of the 2018 Nigeria Demographic and Health Survey

Geopolitical zones differentials in intermittent preventive treatment in pregnancy (IPTp) and long lasting insecticidal nets (LLIN) utilization in Nigeria

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