Controlling Malaria in Pregnancy: Investigating the Factors that Influence the Uptake of Intermittent Preventive Treatment Services in the Nzema-East District, Ghana

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To help reduce the burden of malaria in pregnancy, the Ministry of Health introduced the intermittent preventive treatment (IPT) programme with Sulfadoxine-pyrimethamine (SP) for pregnant women as a national policy in 1999. Nine hundred women from fifty communities in the Nzema-East District were sampled in a cross-sectional household survey in August, 2008 in this study to determine the factors that influence the uptake of IPT services. Majority of the women, 95.1%; CI [93.6 – 96.4] had an encounter with the ANC during their last pregnancies. More than half, 52%; CI [47.7 – 54.3] of the women had their first ANC encounter in the first trimester, and 57.3%; CI [53.8 – 60.2] made four or more visits to the ANC before delivery. Even though ANC attendance was high, only 47.2%; CI [43.1 - 50.8] of the 641 women who took SP as IPT had three doses. Women who lacked formal education were more likely not to have complete IPT (OR 1.5; CI 1.23 – 1.69). Employment, marital status, educational level, number of ANC visits and gestational age at first ANC visit were significant predictors of IPT uptake (p < 0.05). Education on the benefits of IPT for the woman and the unborn child, and the negative consequences of malaria in pregnancy should be emphasised at ANC sessions. There should be conscious effects to ensure continuous supply of SP to health facilities. Community health workers should be trained to administer SP at the community level.
Thesis Submitted to the Department Of Community Health, School of Medical Sciences, College Of Health Sciences, Kwame Nkrumah University Of Science And Technology In Partial Fulfillment Of The Requirements For The Award Of Master Science Degree In Health Education And Promotion