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The readiness of malaria services and uptake of intermittent preventive treatment in pregnancy in six sub-Saharan countries.
- Source :
-
Journal of global health [J Glob Health] 2024 Jun 28; Vol. 14, pp. 04112. Date of Electronic Publication: 2024 Jun 28. - Publication Year :
- 2024
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Abstract
- Background: Malaria infection during pregnancy is associated with an increased risk of maternal death, as well as adverse birth outcomes. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is known to improve pregnancy outcomes. However, the coverage of IPTp-SP in antenatal care (ANC) in sub-Saharan Africa remains well below the target. This study aims to estimate to what extent malaria service readiness affects the uptake of IPTp-SP during ANC visits in sub-Saharan African countries.<br />Methods: This study included 3267 pregnant women attending ANC for the first time and 2797 pregnant women who had attended ANC more than a month ago in six sub-Saharan African countries. The readiness of malaria services at each institution includes four indicators: the presence of IPTp-SP guidelines, SP availability, integration of IPTp-SP service into ANC, and provider training on IPTp-SP. The outcome variable indicates whether a pregnant woman received IPTp-SP at her current ANC visit. A modified Poisson regression model estimated the associations between malaria service readiness and IPTp-SP uptake for women eligible for the first and subsequent doses.<br />Results: For women eligible for their first dose, visiting an institution with available SP was associated with an increased probability of receiving IPTp-SP (risk ratio (RR) = 1.43; 95% confidence interval (CI) = 1.22 to 1.67, P < 0.001). For women who were eligible for their next dose, the availability of SP (RR = 1.17; 95% CI = 1.04 to 1.32, P = 0.008) and integration of IPTp-SP service into ANC (RR = 1.82; 95% CI = 1.21 to 2.74, P = 0.004) in the institution were associated with increased likelihood of IPTp-SP uptake. Counterfactual predictions indicated that enhanced provider training could boost IPTp-SP uptake in high-uptake countries, while better SP availability and IPTp-SP integration into ANC would significantly impact low-uptake countries.<br />Conclusions: For better IPTp-SP coverage, strategies should be customised. High uptake countries should focus on provider training, while low uptake ones should ensure IPTp-SP availability and service integration.<br />Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclosed no relevant interests.<br /> (Copyright © 2024 by the Journal of Global Health. All rights reserved.)
- Subjects :
- Humans
Female
Pregnancy
Africa South of the Sahara
Adult
Young Adult
Adolescent
Patient Acceptance of Health Care statistics & numerical data
Antimalarials therapeutic use
Pyrimethamine therapeutic use
Pyrimethamine administration & dosage
Sulfadoxine therapeutic use
Sulfadoxine administration & dosage
Malaria prevention & control
Pregnancy Complications, Parasitic prevention & control
Drug Combinations
Prenatal Care statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 2047-2986
- Volume :
- 14
- Database :
- MEDLINE
- Journal :
- Journal of global health
- Publication Type :
- Academic Journal
- Accession number :
- 38939971
- Full Text :
- https://doi.org/10.7189/jogh.14.04112