Factors Contributing to Low IPTp3+ Uptake in the Biakoye District of the Volta Region of Ghana

Abstract

Malaria infection during pregnancy is a major public health problem, with substantial risks for the mother, her foetus and the new-born.(PATH, 2014b). In Ghana, the proportion of OPD cases attributed to malaria in pregnancy 2.7%, 6.7% of admissions and 1% deaths in 2014. In areas with moderate to high transmission of Plasmodium falciparum, the World Health Organization (WHO) recommends the administration of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) by pregnant women as part of package of interventions for controlling malaria and its effects during pregnancy, which also includes the promotion and use of insecticide-treated nets (ITNs) and appropriate case management through prompt and effective treatment of malaria in pregnant women.(WHO, 2014). This main objective of this research is to ascertain the contributory factors to low IPTp3+ in the Biakoye district of the Volta region of Ghana. Methodology A cross-sectional study was conducted, where women within one year postpartum and attended antenatal in the Biakoye District were interviewed using a structured questionnaire. A sample size of 384 women was involved in the survey and STATA® software used to analyse and present the results in tables and graphs. Results The research found that 81.09% of respondents visited antenatal clinic four (4) or more times and 99% visited antenatal care clinic once. About 64.2% of respondents registered in the first trimester giving them the opportunity to attain adequate ANC visit and 76.1% of mothers said they were satisfied and 18.7% very satisfied. On Malaria transmission, 84.62% of respondents adequately identified the mosquito to be responsible for malaria transmission and 75.8% displayed adequate knowledge on the importance of IPTp in pregnancy; of these 53.41% said it prevents malaria, 18.3% said it treats malaria. The study revealed that 54% of respondents had adequate IPTp uptake (that is, more than three (3) doses). And finally the following were the factors that really affected IPTp3+ uptake: • Women below twenty six (26) years showed low (48.19%)uptake of IPTp3+ • Attending lower health care facilities (Health Centres) was shown to adversely affect IPTp3+ uptake (48.85%) as compared to attending hospital (51.15%). • Women with higher education were 66% more likely to have adequate IPTp than those with no education (30%) or Low (58.26%) educational level. • Occupation; Women in the formal sector were shown (55.56 %.) not to do so very well in adequate IPTp uptake. Conclusion As has been demonstrated by the findings of this study, the interventions to encourage women to attend ANC has been very successful. This strategy should be sustained and improved in areas where they fall short, especially at the smaller facilities. The gains made in ANC attendance have however not translated into an equally impressive level of IPTp3+ uptake. To address this challenge, a more targeted approach to the various interventional strategies should be undertaken, by focusing more on identified vulnerable segments of the people including young pregnant women and those women who are economically and socially disadvantaged.