Factors Influencing adherence to New intermittent Preventive Treatment of Malaria In Pregnancy Policy In Keta District In Volta Region, Ghana.

Abstract

Background Malaria is a notable public health problem despite implementation of several preventive strategies. Over 90% of malaria related deaths in the world is in Sub Saharan Africa. About 25% of pregnant women are infected with malaria in areas endemic for malaria and accounts for about 15% of maternal death globally. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is one of the main strategies for prevention of malaria in pregnancy. A new recommendation was made by WHO that at least three (3) doses of IPTp-SP should be administered before delivery. The rate of IPTp-SP adherence is moving slowly in places like the Volta region in Ghana. This study seeks to determine the factors influencing adherence to new IPTp-SP policy in Keta District, Volta region, Ghana. Method – A cross sectional quantitative study among 375 nursing mothers and all health workers at the antenatal clinic (ANC) at four (4) selected health facilities in Keta district, Ghana. The study was conducted from May to July, 2018 using a structured questionnaire to interview participants. Factors such as sociodemographic, individual and institutional factors were analyzed to determine if they influence adherence to IPTp-SP. Data was analyzed using STATA 15. Chi square was used to test association between categorical variables and adherence. Regression analysis was used to determine the factors influencing adherence to IPTp-SP. Result - About 82.1% of participants adhered to the WHO policy recommendations of at least 3 doses of IPTp. However, only 17.1% received Ghana’s 5 dose coverage recommendation. The proportion of IPTp-SP coverage for IPT1 was 98.9%; IPT2 95.5%; IPT3 80.8%; IPT4 39.5%; IPT5 17.1%. Gestational age at first IPT and ANC, Sociodemographic factors (age and University of Ghana http://ugspace.ug.edu.gh vi educational level) and number of ANC visits were significantly associated with adherence to IPTp. Conclusion: - Adherence to IPTp was satisfactory according to WHO’s policy recommendation but however majority of the participants had less than the 5 dose coverage recommendation in Ghana. Number of ANC visits and knowledge of malaria were the main determinants of adherence to IPTp-SP.