Determinants of Uptake of Intermittent Preventive Treatment for Malaria among Pregnant Women in Suba Sub-County, Homa-Bay County
Abstract/ Overview
Malaria is a disease caused by protozoan parasites of Plasmodium species and is transmitted by the bites of infected female Anopheles mosquitoes. In areas of moderate to high malaria transmission, pregnant women are more prone to malaria infection. In these settings, malaria in pregnancy is associated with low birth weight, premature delivery, and stillbirth as well as maternal anaemia. The strategy recommended by the World Health Organization and Kenya National Policy guidelines for the prevention of malaria in pregnancy is the use of intermittent preventive treatment in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP). However, the use of IPTp-SP remains sub-optimal in Kenya, and specifically in the study area. In Kenya, only 37% of pregnant women received three or more doses of IPTp despite ANC clinic utilization of 94%, while in Suba the coverage was 41,5%. The purpose of this study was, therefore, to investigate determinants of uptake of Intermittent Preventive Treatment for malaria among pregnant women in Suba Sub-County in Homa-Bay County. Specifically, the study sort to: found out socio demographic determinants of IPTp-SP uptake for malaria among pregnant women, establish knowledge related determinants of uptake of IPTp-SP among pregnant women, and identify environmental determinants of uptake of IPTp-SP among pregnant women in Suba Sub-County. This study applied a descriptive cross-sectional study design. The household survey was conducted targeting all women who had a live birth in the last 24 months before the study and who had sought antenatal care in one of the health facilities in the Sub County. A systematic random sampling method was used to identify the respondents from the list of those mothers who sought ANC services in 2017-2019. Using a structured questionnaire, a total of 382 women were interviewed who were randomly selected from a study population of 4797. Data were analysed using STATA version 13. The findings of this research were presented in narrative, using tables and figures. Of the 382 women who were interviewed, all the respondents attended at least one ANC clinic, 63 (16.5%) had taken IPTp-SP once during their pregnancy, 99 (25.9%) had taken IPTp-SP twice and 220 (57.6%) had taken the recommended three or more doses of IPTp-SP. The study revealed that Women who visited ANC clinic less than three times during their last pregnancy had a marginally significant lower odd of receiving three or more doses of IPTp (OR=.0.05), compared with women who visited the clinic more than three times, similarly women who stayed more than 6Km away from health facility were less likely to receive three or more doses of IPTp (OR=0.31) compared to women who stayed less than 6Km.In conclusion, the study established that marital status, occupation, gestational age at first ANC clinic, ANC attendance of three or more, distance to the nearest health facility, and means of transport were all determinants found to be statistically significantly associated with receiving three or more doses of IPTp. The study, therefore, recommends continuous health education at both health facility and community level on prevention of malaria in pregnancy using IPTp, use of community health services by involving all community health volunteers, and health systems strengthening through partners.