Factors affecting uptake of ≥ 3 doses of Sulfadoxine-Pyrimethamine for malaria prevention in pregnancy in selected health facilities, Arusha region, Tanzania
Abstract Background Tanzania adopted the revised World Health Organization policy in 2013 recommending a minimum of ≥3 doses of Intermittent Preventive Treatment during pregnancy with Sulfadoxine-Pyrimethamine (IPTp-SP) to protect against malaria. A study in Tanzania in 2014 reported low (9%) uptake...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-11-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12884-019-2592-0 |
| _version_ | 1819114413098008576 |
|---|---|
| author | Witness Mkalukwatage Mchwampaka Donath Tarimo Frank Chacky Ahmed Mohamed Rogath Kishimba Angela Samwel |
| author_facet | Witness Mkalukwatage Mchwampaka Donath Tarimo Frank Chacky Ahmed Mohamed Rogath Kishimba Angela Samwel |
| author_sort | Witness Mkalukwatage Mchwampaka |
| collection | DOAJ |
| description | Abstract Background Tanzania adopted the revised World Health Organization policy in 2013 recommending a minimum of ≥3 doses of Intermittent Preventive Treatment during pregnancy with Sulfadoxine-Pyrimethamine (IPTp-SP) to protect against malaria. A study in Tanzania in 2014 reported low (9%) uptake. We investigated health workers knowledge about IPTp-SP and factors that influenced uptake of > 3 doses of IPTp-SP among pregnant women. Methods We conducted a cross-sectional study in 2017 among post-delivery women and health care workers from nine randomly-selected public health facilities in three Districts of Arusha Region. Probability proportional to size methodology was used to determine number of participants per facility. We used a structured questionnaire to collect socio-demographic and obstetric data, information on doses of SP received, and knowledge of SP for IPTp. Health care workers were interviewed about their knowledge for IPTp- SP and challenges encountered in its uptake and use. Results We interviewed 556 persons (median age 26 years, range 16–42 years) with the response rate of 99.3%. Of these, 484 (87.1%) had > 3 Antenatal Care (ANC) visits. A total of 402 (72.3%) were multigravida with 362 (65.1%) having given birth at least once. Of the 556 participants, 219 (39.4%) made their first ANC booking at < 17 weeks of pregnancy and 269 (48.4%) had received > 3 doses of SP-IPTp. Factors associated with uptake of > 3 doses of IPTp-SP included having secondary or higher education [Adjusted Odds Ratio (AOR) =1.6, 95%CI 1.1–2.4], attending ≥4 ANC visits [AOR = 3.1, 95%CI 2.1–4.6], having first antenatal booking at < 17 weeks [AOR = 1.8, 95%CI 1.4–2.3], and adequate knowledge on IPTp-SP [AOR = 2.7, 95%CI 1.9–3.9]. Among 36 health care workers interviewed, 29(80.6%) had adequate knowledge about IPTp-SP. SP was available in seven (87.5%) of the visited health facilities and was administered under Direct Observed Therapy (DOT) in six (75%) facilities. Health care workers reported that stock outs of SP was a challenge. Conclusions Fewer than half of the women interviewed reported uptake of > 3 doses of IPTp-SP. That is below the Tanzania national target of 80%. Making > 4 ANC visits, having secondary or higher education, making an early first ANC visit and having adequate knowledge on IPTp-SP promoted uptake of > 3 doses. Further qualitative studies are needed to explore factors that might contribute to low uptake of SP. |
| first_indexed | 2024-12-22T04:44:54Z |
| format | Article |
| id | doaj.art-925542dc04414d748b8b5f5fbbfdae9e |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-22T04:44:54Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-925542dc04414d748b8b5f5fbbfdae9e2022-12-21T18:38:38ZengBMCBMC Pregnancy and Childbirth1471-23932019-11-011911810.1186/s12884-019-2592-0Factors affecting uptake of ≥ 3 doses of Sulfadoxine-Pyrimethamine for malaria prevention in pregnancy in selected health facilities, Arusha region, TanzaniaWitness Mkalukwatage Mchwampaka0Donath Tarimo1Frank Chacky2Ahmed Mohamed3Rogath Kishimba4Angela Samwel5Mount Meru Regional Referral Hospital (MMRRH), Preventive SectionMuhimbili University of Health and Allied Sciences (MUHAS)Tanzania National Malaria Control Programme (NMCP)Tanzania Field Epidemiology and Laboratory Training Programme (TFELTP)Tanzania Field Epidemiology and Laboratory Training Programme (TFELTP)Tanzania Field Epidemiology and Laboratory Training Programme (TFELTP)Abstract Background Tanzania adopted the revised World Health Organization policy in 2013 recommending a minimum of ≥3 doses of Intermittent Preventive Treatment during pregnancy with Sulfadoxine-Pyrimethamine (IPTp-SP) to protect against malaria. A study in Tanzania in 2014 reported low (9%) uptake. We investigated health workers knowledge about IPTp-SP and factors that influenced uptake of > 3 doses of IPTp-SP among pregnant women. Methods We conducted a cross-sectional study in 2017 among post-delivery women and health care workers from nine randomly-selected public health facilities in three Districts of Arusha Region. Probability proportional to size methodology was used to determine number of participants per facility. We used a structured questionnaire to collect socio-demographic and obstetric data, information on doses of SP received, and knowledge of SP for IPTp. Health care workers were interviewed about their knowledge for IPTp- SP and challenges encountered in its uptake and use. Results We interviewed 556 persons (median age 26 years, range 16–42 years) with the response rate of 99.3%. Of these, 484 (87.1%) had > 3 Antenatal Care (ANC) visits. A total of 402 (72.3%) were multigravida with 362 (65.1%) having given birth at least once. Of the 556 participants, 219 (39.4%) made their first ANC booking at < 17 weeks of pregnancy and 269 (48.4%) had received > 3 doses of SP-IPTp. Factors associated with uptake of > 3 doses of IPTp-SP included having secondary or higher education [Adjusted Odds Ratio (AOR) =1.6, 95%CI 1.1–2.4], attending ≥4 ANC visits [AOR = 3.1, 95%CI 2.1–4.6], having first antenatal booking at < 17 weeks [AOR = 1.8, 95%CI 1.4–2.3], and adequate knowledge on IPTp-SP [AOR = 2.7, 95%CI 1.9–3.9]. Among 36 health care workers interviewed, 29(80.6%) had adequate knowledge about IPTp-SP. SP was available in seven (87.5%) of the visited health facilities and was administered under Direct Observed Therapy (DOT) in six (75%) facilities. Health care workers reported that stock outs of SP was a challenge. Conclusions Fewer than half of the women interviewed reported uptake of > 3 doses of IPTp-SP. That is below the Tanzania national target of 80%. Making > 4 ANC visits, having secondary or higher education, making an early first ANC visit and having adequate knowledge on IPTp-SP promoted uptake of > 3 doses. Further qualitative studies are needed to explore factors that might contribute to low uptake of SP.http://link.springer.com/article/10.1186/s12884-019-2592-0IPTp-SP uptakeMalaria preventionTanzania |
| spellingShingle | Witness Mkalukwatage Mchwampaka Donath Tarimo Frank Chacky Ahmed Mohamed Rogath Kishimba Angela Samwel Factors affecting uptake of ≥ 3 doses of Sulfadoxine-Pyrimethamine for malaria prevention in pregnancy in selected health facilities, Arusha region, Tanzania BMC Pregnancy and Childbirth IPTp-SP uptake Malaria prevention Tanzania |
| title | Factors affecting uptake of ≥ 3 doses of Sulfadoxine-Pyrimethamine for malaria prevention in pregnancy in selected health facilities, Arusha region, Tanzania |
| title_full | Factors affecting uptake of ≥ 3 doses of Sulfadoxine-Pyrimethamine for malaria prevention in pregnancy in selected health facilities, Arusha region, Tanzania |
| title_fullStr | Factors affecting uptake of ≥ 3 doses of Sulfadoxine-Pyrimethamine for malaria prevention in pregnancy in selected health facilities, Arusha region, Tanzania |
| title_full_unstemmed | Factors affecting uptake of ≥ 3 doses of Sulfadoxine-Pyrimethamine for malaria prevention in pregnancy in selected health facilities, Arusha region, Tanzania |
| title_short | Factors affecting uptake of ≥ 3 doses of Sulfadoxine-Pyrimethamine for malaria prevention in pregnancy in selected health facilities, Arusha region, Tanzania |
| title_sort | factors affecting uptake of ≥ 3 doses of sulfadoxine pyrimethamine for malaria prevention in pregnancy in selected health facilities arusha region tanzania |
| topic | IPTp-SP uptake Malaria prevention Tanzania |
| url | http://link.springer.com/article/10.1186/s12884-019-2592-0 |
| work_keys_str_mv | AT witnessmkalukwatagemchwampaka factorsaffectinguptakeof3dosesofsulfadoxinepyrimethamineformalariapreventioninpregnancyinselectedhealthfacilitiesarusharegiontanzania AT donathtarimo factorsaffectinguptakeof3dosesofsulfadoxinepyrimethamineformalariapreventioninpregnancyinselectedhealthfacilitiesarusharegiontanzania AT frankchacky factorsaffectinguptakeof3dosesofsulfadoxinepyrimethamineformalariapreventioninpregnancyinselectedhealthfacilitiesarusharegiontanzania AT ahmedmohamed factorsaffectinguptakeof3dosesofsulfadoxinepyrimethamineformalariapreventioninpregnancyinselectedhealthfacilitiesarusharegiontanzania AT rogathkishimba factorsaffectinguptakeof3dosesofsulfadoxinepyrimethamineformalariapreventioninpregnancyinselectedhealthfacilitiesarusharegiontanzania AT angelasamwel factorsaffectinguptakeof3dosesofsulfadoxinepyrimethamineformalariapreventioninpregnancyinselectedhealthfacilitiesarusharegiontanzania |