Factors Associated with Uptake of Intermittent Preventive Treatment Of Malaria in Pregnancy in Ningo Prampram District of Greater Accra, Ghana.

Abstract

Introduction: Malaria is endemic throughout Ghana with pregnant women and children under five years, having a higher risk of severe illness. Ghana adopted a new IPTp-SP of MIP policy in 2004, which was updated in 2014, to reflect the updated policy of WHO 2012. In 2017, uptake of IPTp3 was 43.0%, and IPTp5 was 8.9%, which was below the target of 80%. The study aimed at assessing IPTp-SP uptake and associated factors in the Ningo Prampram District. Methods: An analytical study was carried out in July 2020 in Ningo Prampram District. Data were collected from women who had delivered within the past six months using structure questionnaires. Their ANC books were also reviewed to extract obstetric data. Midwives were interviewed concerning their knowledge and practices towards IPTp-SP. Data on health facilities readiness to provide IPTp-SP were also collected using a check-list. The quantitative and qualitative data were analysed using Stata16 and thematically, respectively. Results: The postnatal mothers were recruited from five public health facilities. Among all participants, 6.1 % did not take any IPTp; those that took IPTp1 were 93.9%, IPTp2 82.5%, IPTp3 62.8%, IPTp4 31.1%, IPTp5 15.3% and IPTp6 0.4%, with reasons from HCWs for the low uptake like, “ patients have rights if they say no to taking a drug because of previous experiences, I can’t force them, or else they will run away and never come back for other services.” hwc8. Regardless of this, all HCWs had good knowledge and practices. Of the 23 variables evaluated, only Gestation age at IPTp1(AOR=0.33, P=0.012) and Knowledge about IPTp-SP (AOR=5.7, P=0.022) were statistically significant in multivariate analysis as factors affecting IPTp5 uptake.Most facilities had medium facility readiness to provide IPTp for pregnant women. Conclusion: This study found that IPTp-SP uptake fell below the NMCP national targets for IPTp1,2,3,4, and 5 among the postnatal mothers. With factor such as voluntary refusal to take the drug, SP stock out issues and ineligibility to take SP drug.