Uptake Of The Sulfadoxine-Pyrimethamine Five Dose Policy In Ghana Following Four Years Of Implementation: A Cross- Sectional Survey Among Postnatal Care Attendees In Mamprobi Polyclinic

Abstract

Introduction. Malaria in pregnancy is one of the leading causes of maternal and neonatal morbidity and mortality in sub Saharan Africa and in Ghana. Several measures have been put in place in a bit to curb the menace and one of them is the use of intermittent preventive treatment of malaria using sulphadoxine pyrimethamine IPT-SP drug. It is taken every one or at least four weeks apart from 16 weeks or the second trimester till delivery. Objective. The goal of this study was to determine the impact of the new WHO policy on antenatal care (ANC) attendance and its effect on the uptake of IPT-SP program. Methodology: A descriptive cross sectional study design was used for the study and it involved a consecutive sample size of 280 postnatal mothers within 12 weeks of delivery at the Mamprobi Policlinic. Data on uptake of IPT-SP (primary dependent variable) and independent variables: ANC visit timing (trimester at first visit to ANC). ANC visit t frequency (monthly/not-monthly), and number of ANC visits, was retrospectively collected from antenatal records of respondents using a structured form. Data on socio demographic information, including health facility factors was also collected from primary respondents and health facility staff respectively. Simple chisquare statistic and charts were used to examine descriptive relationships between variables, and logistic regression used to examine associations between the dependent and independent variables: effect sizes are reported as odds ratios with 95% confidence intervals. Data analysis was conducted with STATA version 15.0 Results: A total number of 284 postnatal mothers with 12 weeks of delivery consented for this study and were used for the analysis. Out of that of sample, 45.8 % of participants received the optimal 5 doses of SP in their previous pregnancy, 62% of the participants had 8 and above ANC visits. For the number of participants who made less than 8 visits, 30.3% received the optimal 5 doses of SP. Among the participants who made 8 and more visits 69.7% received 5 doses of SP. There is a significant relationship between number of ANC (x² =3.83, p=:0.005. ɑ=0.05) and SP uptake. Participants making 8 ANC visits were 1.22 times more likely to receive 5 dose of SP compared to women making less than 8 visits with an [AOR= 1.22 (95% CI(: 0.45 -1.1 2): p=0.008] Conclusion The WHO new recommended 5 doses of SP uptake in Mamprobi was low in the study population despite the high number of ANC visits. Number of pregnancies and increased number of ANC visits has increased odds for the uptake of SP. However, women with more children have a lower chance of receiving the optimal doses of SP. At health facilities, lack of capacity building activities on SP for ANC staff, inadequate staff and intermittent shortage of SP were identified to be predictors for the uptake of SP.