Perceptions of intermittent preventive treatment of malaria in pregnancy (IPTp) and barriers to adherence in Nasarawa and Cross River States in Nigeria

Malaria Journal

Research

Thaddeus Pennas¹  Chamberlain C Diala¹  Celeste Marin²  Kassahun A Belay³ 

[1] FHI360, C-Change Project, Global Health Population and Nutrition Division, 1825 Connecticut Avenue, NW 20009, Washington, DC, USA;New Haven, CT, USA;US Agency for International Development (USAID), Abuja, Nigeria;

关键词: Malaria in pregnancy;    Intermittent preventive treatment in pregnancy;    Sulphadoxine-pyrimethamine;    Antenatal care;    Focus group discussions;    In-depth individual interviews;    Cross River State;    Nasarawa State;   

DOI  :  10.1186/1475-2875-12-342

 received in 2013-05-20, accepted in 2013-09-13,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundMalaria during pregnancy is dangerous to both mother and foetus. Intermittent preventive treatment of malaria in pregnancy (IPTp) is a strategy where pregnant women in malaria-endemic countries receive full doses of sulphadoxine-pyrimethamine (SP), whether or not they have malaria. The Nigerian government adopted IPTp as a national strategy in 2005; however, major gaps affecting perception, uptake, adherence, and scale-up remain.MethodsA cross-sectional study was conducted in peri-urban and rural communities in Nasarawa and Cross River States in Nigeria. Study instruments were based on the socio-ecological model and its multiple levels of influences, taking into account individual, community, societal, and environmental contexts of behaviour and social change. Women of reproductive age, their front-line care providers, and (in Nasarawa only) their spouses participated in focus group discussions and in-depth individual interviews. Facility sampling was purposive to include tertiary, secondary and primary health facilities.ResultsThe study found that systems-based challenges (stockouts; lack of provider knowledge of IPTp protocols) coupled with individual women’s beliefs and lack of understanding of IPT contribute to low uptake and adherence. Many pregnant women are reluctant to seek care for an illness they do not have. Those with malaria often prefer to self-medicate through drug shops or herbs, though those who seek clinic-based treatment trust their providers and willingly accept medicine prescribed.ConclusionsFailing to deliver complete IPTp to women attending antenatal care is a missed opportunity. While many obstacles are structural, programmes can target women, their communities and the health environment with specific interventions to increase IPTp uptake and adherence.

【 授权许可】

CC BY   
© Diala et al.; licensee BioMed Central Ltd. 2013