FACTORS INFLUENCING THE UPTAKE OF INTERMITTENT PREVENTIVE TREATMENT OF MALARIA AMONG PREGNANT WOMEN IN THE GUSHEGU DISTRICT, NORTHERN REGION, GHANA

ABSTRACT

Background: Despite reducing from 451 in 2007 to 350 in 2010 per 100,000 live births, Ghana has a high maternal mortality rate. NMCP target for IPTp2 is 80%, Ghana‟s coverage was 64.4% in 2011.This contrasts with 84.7% ANC attendance coverage for at least 4 visits. Northern Regional IPTp2 coverage is lower than the national average at 51.2%. In Gushegu 44% registered pregnant women received IPTp2 in 2013. Low IPTP coverage is a threat to reducing malaria incidence and maternal mortality. The primary objective of the study was to determine the client and facility related factors associated with adequate uptake of IPTp.

Methods: A cross sectional study was conducted among ANC clients and staffs of the Gushegu RCH. Questionnaires were administered to 330 conveniently sampled nursing mothers and filled by ANC staff. A checklist was used for health facility observations. Univariate analyses of variables were expressed as frequencies and proportions. Bivariate analysis was used to show associations between the various independent and the dependent variables,

Results: A total of 8.5% and 91.5% of respondents took inadequate (≤1dose) and adequate (≥2doses) IPTp-SP respectively. 85.4% respondents made early first ANC attendance, 92% are unemployed and 80% multiple gravidae. Mean ANC visits is 5. Mean gestational age at first attendance for inadequate and adequate dosage is 6 and 4 respectively. 25% and 15.5% reported side effects and malaria infection after SP use respectively. The odds ratios at 95%CI of Unemployment, single gravidae and late first ANC visit to predicting inadequate SP uptake were OR4.9 (1.88-13.14.), OR3.38 (1.52-7.55) and OR6.8 (2.96-15.40) respectively.

DOT practice, good staff attitude and health talks at the facility was observed and confirmed by 96.7%, 94% and 87.2% of clients. ITNs coverage is 23% and usage72%.

 Conclusion: Adequate uptake of SP among respondents was high. Majority were unemployed, have had multiple pregnancies and made early first ANC visits. The mean number of ANC visits meets WHO standards. Unemployment, single parity and late first ANC visits are significantly associated with taking inadequate SP dose. ANC staff attitude and practices are satisfactory. The coverage of ITNs is low but its use is high among the respondents.