Predictors Of Sulphadoxine-Pyrimethamine Uptake Among Pregnant Women, Asante Akim North District
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Date
2021-12
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University of Ghana
Abstract
ABSTRACT
Background: Given the public health implications of malaria in pregnancy (MiP), Intermittent Preventive Treatment of Malaria in Pregnancy using Sulphadoxine Pyrimethamine is one of the three interventions recommended by the World Health Organization for the prevention of MiP. However, uptake levels have generally been low in Ghana over the years including the Asante Akim North district. The district recorded 55.0% IPTp-SP3 uptake in 2019which is far below the 80% national targets. This study assessed the predictors of IPTp-SP uptake among pregnant women in the Asante Akim North District.
Methods: A hospital-based cross-sectional study was conducted, involving 423 randomly sampled postnatal women in selected health facilities in the Asante Akim North District from September to October, 2021through interview using a structured questionnaire and records review with an observational checklist. Continuous variables were presented as means and standard deviation, with categorical variables presented as frequencies and proportions. Chi square test was computed to determine association between IPT3 uptake and independent variables, whiles logistic regression was used to determine strength of associations at a significance level of 95% Confidence interval and 5% p value.
Results: Out of the 423 postnatal women studied, 271 (64.7%) received 3 or more doses of IPTp-SP. Majority 371 (87.7%) made at least four antenatal visits throughout their entire pregnancy. A total of 316 (74.7%) had been multigravid whilst179 (42.3%) of the respondents, had at least three children. Postnatal women who made four or more ANC visits had 6.57 times increased odds of uptake compared with women who made less than four ANC visits (aOR = 6.57, 95% CI 1.13, 38.09, p < 0.036). Multigravid postnatal women had 94% reduced odds of uptake compared to primigravid postnatal women (aOR = 0.06, 95% CI 0.01, 0.49, p < 0.010). Women who made
Payments for ultrasound scan had 98% reduced odds of uptake compared with those who made no payment (aOR = 0.02, 95% CI 0.004, 0.87, p <0.042) whilst those who made payment for other medications had 12.57 times increased odds of uptake (aOR = 12.57, 95% CI 2.40, 65.93, p <0.003) compared to those who did not make payment.
Conclusion: The uptake of IPTp-SP3 in the Asante Akim North district was less than the 80% recommended uptake level. Gravidity and antenatal attendance were positively associated with uptake of three or more doses of IPTp-SP whiles co-payments for ultrasound scan and other medications was negatively associated with taking IPTp-SP3. Midwives and other stakeholders including the National Malaria Control Programme should target multigravida women, those who are economically dependent, those who pay for other services and those who do not make the recommended ANC visit to improve uptake.
Description
MPhil In Applied Epidemiology and Disease Control Degree
Keywords
IPTp-SP, Asante Akim, postnatal, Ghana