Barriers to and determinants of the use of intermittent preventive treatment of malaria in pregnancy in Cross River State, Nigeria: A cross-sectional study

Soter Ameh; Eme Owoaje; Angela Oyo-Ita; Caroline W. Kabiru; Obaji E.O. Akpet; Aniekan Etokidem; Okokon Enembe; Nnette Ekpenyong

doi:10.1186/s12884-016-0883-2

Barriers to and determinants of the use of intermittent preventive treatment of malaria in pregnancy in Cross River State, Nigeria: A cross-sectional study

Soter Ameh, Eme Owoaje, Angela Oyo-Ita, Caroline W. Kabiru, Obaji E.O. Akpet, Aniekan Etokidem, Okokon Enembe, Nnette Ekpenyong

Research output: Contribution to journal › Article › peer-review

23 Citations (Scopus)

Abstract

Background: Malaria in pregnancy (MIP) has serious consequences for the woman, unborn child and newborn. The use of sulfadoxine-pyrimethamine for the intermittent preventive treatment of malaria in pregnancy (SP-IPTp) is low in malaria endemic areas, including some regions of Nigeria. However, little is known about pregnant women's compliance with the SP-IPTp national guidelines in primary health care (PHC) facilities in the south-south region of Nigeria. The aim of this study was to identify the barriers to and determinants of the use of SP-IPTp among pregnant women attending ANC in PHC facilities in Cross River State, south-south region of Nigeria. Methods: A cross-sectional survey was conducted in 2011 among 400 ANC attendees aged 15-49 years recruited through multistage sampling. Binary logistic regression was used to determine the factors associated with the use of SP-IPTp in the study population. Results: Use of SP-IPTp was self-reported by 41 % of the total respondents. Lack of autonomy in the households to receive sulfadoxine-pyrimethamine (SP) during ANC was the main barrier to use of IPTp (83 %). Other barriers were stock-outs of free SP (33 %) and poor supervision of SP ingestion by directly observed treatment among those who obtained SP from ANC clinics (36/110 = 33 %). In the multivariate logistic regression, the odds of using SP-IPTp was increased by the knowledge of the use of insecticide treated nets (ITNs) (OR = 2.13, 95 % CI: 1.70-3.73) and SP (OR = 22.13, 95 % CI: 8.10-43.20) for the prevention of MIP. Use of ITNs also increased the odds of using SP-IPTp (OR = 2.38, 95 % CI: 1.24-12.31). Conclusions: Use of SP-IPTp was low and was associated with knowledge of the use of ITNs and SP as well as the use of ITNs for the prevention of MIP. There is a need to strengthen PHC systems and address barriers to the usage of SP-IPTp in order to reduce the burden of MIP.

Original language	English
Article number	99
Pages (from-to)	1-9
Number of pages	9
Journal	BMC Pregnancy and Childbirth
Volume	16
Issue number	1
DOIs	https://doi.org/10.1186/s12884-016-0883-2
Publication status	Published - 4 May 2016
Externally published	Yes

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@article{d8e059d8c7684966a73e0b82488920e1,

title = "Barriers to and determinants of the use of intermittent preventive treatment of malaria in pregnancy in Cross River State, Nigeria: A cross-sectional study",

abstract = "Background: Malaria in pregnancy (MIP) has serious consequences for the woman, unborn child and newborn. The use of sulfadoxine-pyrimethamine for the intermittent preventive treatment of malaria in pregnancy (SP-IPTp) is low in malaria endemic areas, including some regions of Nigeria. However, little is known about pregnant women's compliance with the SP-IPTp national guidelines in primary health care (PHC) facilities in the south-south region of Nigeria. The aim of this study was to identify the barriers to and determinants of the use of SP-IPTp among pregnant women attending ANC in PHC facilities in Cross River State, south-south region of Nigeria. Methods: A cross-sectional survey was conducted in 2011 among 400 ANC attendees aged 15-49 years recruited through multistage sampling. Binary logistic regression was used to determine the factors associated with the use of SP-IPTp in the study population. Results: Use of SP-IPTp was self-reported by 41 % of the total respondents. Lack of autonomy in the households to receive sulfadoxine-pyrimethamine (SP) during ANC was the main barrier to use of IPTp (83 %). Other barriers were stock-outs of free SP (33 %) and poor supervision of SP ingestion by directly observed treatment among those who obtained SP from ANC clinics (36/110 = 33 %). In the multivariate logistic regression, the odds of using SP-IPTp was increased by the knowledge of the use of insecticide treated nets (ITNs) (OR = 2.13, 95 % CI: 1.70-3.73) and SP (OR = 22.13, 95 % CI: 8.10-43.20) for the prevention of MIP. Use of ITNs also increased the odds of using SP-IPTp (OR = 2.38, 95 % CI: 1.24-12.31). Conclusions: Use of SP-IPTp was low and was associated with knowledge of the use of ITNs and SP as well as the use of ITNs for the prevention of MIP. There is a need to strengthen PHC systems and address barriers to the usage of SP-IPTp in order to reduce the burden of MIP.",

keywords = "Barriers, Cross River State, Determinants, Intermittent preventive treatment of malaria in pregnancy, Nigeria, Sulfadoxine-pyrimethamine, Use",

author = "Soter Ameh and Eme Owoaje and Angela Oyo-Ita and Kabiru, {Caroline W.} and Akpet, {Obaji E.O.} and Aniekan Etokidem and Okokon Enembe and Nnette Ekpenyong",

note = "Funding Information: Financial support for this research was provided by the University of Calabar Teaching Hospital, Calabar, Cross River State. Analysis and writing time for CWK was supported through funding from the Bill and Melinda Gates Foundation (Global Health Grant Number: OPP1021893) and the International Development Research Center (IDRC) (Grant Number: 107508); and through general support grants to the African Population and Health Research Center (APHRC) from the Swedish International Development Cooperation Agency (Grant Number 2011–001578) and the William and Flora Hewlett Foundation (Grant Number 2012–7612). Publication of this article was partly funded by the APHRC. Publisher Copyright: {\textcopyright} 2016 Ameh et al.",

year = "2016",

month = may,

day = "4",

doi = "10.1186/s12884-016-0883-2",

language = "English",

volume = "16",

pages = "1--9",

journal = "BMC Pregnancy and Childbirth",

issn = "1471-2393",

publisher = "BioMed Central",

number = "1",

}

TY - JOUR

T1 - Barriers to and determinants of the use of intermittent preventive treatment of malaria in pregnancy in Cross River State, Nigeria

T2 - A cross-sectional study

AU - Ameh, Soter

AU - Owoaje, Eme

AU - Oyo-Ita, Angela

AU - Kabiru, Caroline W.

AU - Akpet, Obaji E.O.

AU - Etokidem, Aniekan

AU - Enembe, Okokon

AU - Ekpenyong, Nnette

N1 - Funding Information: Financial support for this research was provided by the University of Calabar Teaching Hospital, Calabar, Cross River State. Analysis and writing time for CWK was supported through funding from the Bill and Melinda Gates Foundation (Global Health Grant Number: OPP1021893) and the International Development Research Center (IDRC) (Grant Number: 107508); and through general support grants to the African Population and Health Research Center (APHRC) from the Swedish International Development Cooperation Agency (Grant Number 2011–001578) and the William and Flora Hewlett Foundation (Grant Number 2012–7612). Publication of this article was partly funded by the APHRC. Publisher Copyright: © 2016 Ameh et al.

PY - 2016/5/4

Y1 - 2016/5/4

N2 - Background: Malaria in pregnancy (MIP) has serious consequences for the woman, unborn child and newborn. The use of sulfadoxine-pyrimethamine for the intermittent preventive treatment of malaria in pregnancy (SP-IPTp) is low in malaria endemic areas, including some regions of Nigeria. However, little is known about pregnant women's compliance with the SP-IPTp national guidelines in primary health care (PHC) facilities in the south-south region of Nigeria. The aim of this study was to identify the barriers to and determinants of the use of SP-IPTp among pregnant women attending ANC in PHC facilities in Cross River State, south-south region of Nigeria. Methods: A cross-sectional survey was conducted in 2011 among 400 ANC attendees aged 15-49 years recruited through multistage sampling. Binary logistic regression was used to determine the factors associated with the use of SP-IPTp in the study population. Results: Use of SP-IPTp was self-reported by 41 % of the total respondents. Lack of autonomy in the households to receive sulfadoxine-pyrimethamine (SP) during ANC was the main barrier to use of IPTp (83 %). Other barriers were stock-outs of free SP (33 %) and poor supervision of SP ingestion by directly observed treatment among those who obtained SP from ANC clinics (36/110 = 33 %). In the multivariate logistic regression, the odds of using SP-IPTp was increased by the knowledge of the use of insecticide treated nets (ITNs) (OR = 2.13, 95 % CI: 1.70-3.73) and SP (OR = 22.13, 95 % CI: 8.10-43.20) for the prevention of MIP. Use of ITNs also increased the odds of using SP-IPTp (OR = 2.38, 95 % CI: 1.24-12.31). Conclusions: Use of SP-IPTp was low and was associated with knowledge of the use of ITNs and SP as well as the use of ITNs for the prevention of MIP. There is a need to strengthen PHC systems and address barriers to the usage of SP-IPTp in order to reduce the burden of MIP.

AB - Background: Malaria in pregnancy (MIP) has serious consequences for the woman, unborn child and newborn. The use of sulfadoxine-pyrimethamine for the intermittent preventive treatment of malaria in pregnancy (SP-IPTp) is low in malaria endemic areas, including some regions of Nigeria. However, little is known about pregnant women's compliance with the SP-IPTp national guidelines in primary health care (PHC) facilities in the south-south region of Nigeria. The aim of this study was to identify the barriers to and determinants of the use of SP-IPTp among pregnant women attending ANC in PHC facilities in Cross River State, south-south region of Nigeria. Methods: A cross-sectional survey was conducted in 2011 among 400 ANC attendees aged 15-49 years recruited through multistage sampling. Binary logistic regression was used to determine the factors associated with the use of SP-IPTp in the study population. Results: Use of SP-IPTp was self-reported by 41 % of the total respondents. Lack of autonomy in the households to receive sulfadoxine-pyrimethamine (SP) during ANC was the main barrier to use of IPTp (83 %). Other barriers were stock-outs of free SP (33 %) and poor supervision of SP ingestion by directly observed treatment among those who obtained SP from ANC clinics (36/110 = 33 %). In the multivariate logistic regression, the odds of using SP-IPTp was increased by the knowledge of the use of insecticide treated nets (ITNs) (OR = 2.13, 95 % CI: 1.70-3.73) and SP (OR = 22.13, 95 % CI: 8.10-43.20) for the prevention of MIP. Use of ITNs also increased the odds of using SP-IPTp (OR = 2.38, 95 % CI: 1.24-12.31). Conclusions: Use of SP-IPTp was low and was associated with knowledge of the use of ITNs and SP as well as the use of ITNs for the prevention of MIP. There is a need to strengthen PHC systems and address barriers to the usage of SP-IPTp in order to reduce the burden of MIP.

KW - Barriers

KW - Cross River State

KW - Determinants

KW - Intermittent preventive treatment of malaria in pregnancy

KW - Nigeria

KW - Sulfadoxine-pyrimethamine

KW - Use

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U2 - 10.1186/s12884-016-0883-2

DO - 10.1186/s12884-016-0883-2

M3 - Article

C2 - 27147109

AN - SCOPUS:84970959662

SN - 1471-2393

VL - 16

SP - 1

EP - 9

JO - BMC Pregnancy and Childbirth

JF - BMC Pregnancy and Childbirth

IS - 1

M1 - 99

ER -

Barriers to and determinants of the use of intermittent preventive treatment of malaria in pregnancy in Cross River State, Nigeria: A cross-sectional study

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