Prevalence and health system determinants of uptake of three or more doses of sulphadoxine pyrimethamine for intermittent preventive treatment of malaria during pregnancy

Abstract

Background: Maternal anemia, low birth weight, intrauterine growth retardation and premature births are complications associated with malaria in pregnancy (MIP). In order to prevent malaria, Wold Health Organization (WHO) recommends at least three doses of  Sulphadoxine Pyrimethamine (SP) for Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp-SP3+) during the antenatal period. This study aimed to determine the prevalence and the health system determinants of uptake of three or more doses (IPTp 3+) in Busia  County, Kenya.

Methods: A facility-based cross-sectional study conducted at Busia County Referral Hospital between June and July 2023. Mothers’ in the  Maternity Unit with term deliveries were consecutively sampled. Data on health system factors was collected using interviewer  administered semi-structured questionnaires and interview guides. The statistical significance of health system factors affecting IPTp-SP3+ was dertemined using the odds ratio (OR) and adjusted OR.

Results: The prevalence of IPTp-SP 3+ uptake was 43.0%. Health system factors significantly associated with IPTp-SP 3+ uptake were  facility being too far (aOR = 0.575, 95% CI: 0.351-0.941, p = 0.028) and waiting time being too long (aOR = 0.606, 95% CI: 0.385-0.955, p =  0.031).

Conclusion: Prevalence of uptake of IPTp 3+ is still low, with less than half of the pregnant mothers complying. The County and National  Ministries of Health should make a concerted effort to ensure availability and affordability of SP drugs and also ensure access to and  customer satisfaction at the healthcare facilities.