Factors accounting for the decline in IPTp2/IPTp3 among pregnant mothers in the Keta municipality - Ghana
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Date
2009-07-12
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Abstract
BACKGROUND
Malaria in pregnancy is one of the major causes of maternal morbidity and adverse birth outcomes. In high transmission areas, its prevention has recently changed, moving from a weekly or bimonthly chemoprophylaxis with chloroquine to intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) as recommended by the WHO. The Keta Municipal Health Directorate initiated the SP/IPTp in 2004 with the help from Global Fund for Malaria. Statistics on the coverage revealed a consistent declined in the subsequent two doses (IPTp2 and IPTp3). This study was undertaken to identify factors that influenced the decline in IPTp2 and IPTp3 in the Keta Municipality.
METHODS
In a cross sectional study, 900 eligible women, comprising 302 pregnant women with a gestational age of 28 weeks and more and 598 mothers nursing babies not more than seven months were selected to respond to structured questions on ANC attendance, SP availability and the dosage of SP taken. The Statistical Package for Social Science (SPSS) (version 15.0) was used for data entry and analysis.
RESULTS
Among 893 pregnant mothers, 45%, 51% and 3% of them had their first ANC visit in the first, second and the third trimesters respectively. One percent of them did not attend ANC at all. Over all, ANC attendances were high, 99% at least once; 95% twice and 87% had it three times. The study revealed shortage of SP in ANC facilities. The gestational age at first ANC attendance is significantly associated with SP/IPTp coverage (p<0.0001). Also, the long distance from home to ANC clinic determined the decline in IPTp2/IPTp3.
CONCLUSION
The decline in IPTp2/IPTp3 could be attributed to late ANC booking, shortage of SP in the clinics and the distant location of ANC clinics from many of the communities. There is the need to strengthen SP supplies, making sure it is always available at the health facility level. ANC attendees should be given a holistic education on intermittent preventive treatment in pregnancy. Lastly, community health workers who are all over the communities may be engaged to administer the drug as studies revealed were more effective than the health unit system.
Description
A thesis submitted to the department of community health, Kwame Nkrumah university of science and technology in partial fulfillment of the requirements for the degree of Master of Science
Health Services Planning and Management.