Examining Behavioral, Accessibility, and Sociodemographic Influences on Uptake of Intermittent Preventive Treatment of Malaria in Pregnant Women (IPTp) and Antenatal Care (ANC) Attendance Restricted; Files Only
Rodriguez, Eva (Fall 2023)
Published
Abstract
Background: Sub-Saharan Africa carries much of the global malaria burden, heavily impacting pregnant women. IPTp-SP is a recommended practice for prevention of malaria in pregnant women. We analyzed data to understand the behavioral components that may influence the uptake and effectiveness of IPTp-SP, and to better understand how to target these in order to improve uptake.
Methods: A cross-sectional study of a random sample of women who delivered within the previous 12 months was conducted in Geita, Tanzania to assess the number of doses of IPTp and number of ANC visits women received during pregnancy, at two timepoints: November-December 2019 and June-July 2021. The primary outcomes in this study were the proportion of women who attended at least 4 ANC visits (ANC4) and the proportion who received the recommended 3 or more doses of IPTp (IPTp3). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a logistic regression model for both outcomes in the bivariate and multivariate analyses.
Results: 33% of women received IPTp3. Factors positively associated with IPTp3 included: education, favorable attitude towards IPTp, knowledge of IPTp and ANC, and perception of IPTp use as a community norm. Women were less likely to receive IPTp3 if they were in their third trimester at their first ANC visit and had to travel more than 5 kilometers to the health facility. 42.08% of women attained ANC4. Women with an education, married and living with their spouse were statistically significantly more likely to obtain ANC4 attendance than those with no education. Women were statistically significantly less likely to attain ANC4 attendance if they were in their second and third trimesters at first ANC, if they lived 5 kilometers or more away from the health facility, and if they had 3 or more living children.
Conclusion: We identified additional behaviors associated with IPTp uptake, including a favorable attitude towards IPTp, perception of IPTp effectiveness, and perception of the threat of malaria. Communication and engagement between ANC health workers and the community must be enhanced to properly inform women about IPTp and address negative perceptions surrounding IPTp.
Table of Contents
Literature Review………………………………………………………………………….…….1
Methods……………………………………………………………………………………………6
Results……………………………………………………………………………………………..9
Discussion…………………………………………………………………………………..……16
Conclusion…………………………………………………………………………………….….19
Public Health Implications……………………………………………………………..…….20
References………………………………………………………………………………………..21
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