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Factors affecting uptake of???3 doses of Sulfadoxine-Pyrimethamine for malaria prevention in pregnancy in selected health facilities, Arusha region, Tanzania.


ABSTRACT: BACKGROUND:Tanzania adopted the revised World Health Organization policy in 2013 recommending a minimum of ?3 doses of Intermittent Preventive Treatment during pregnancy with Sulfadoxine-Pyrimethamine (IPTp-SP) to protect against malaria. A study in Tanzania in 2014 reported low (9%) uptake. We investigated health workers knowledge about IPTp-SP and factors that influenced uptake of >?3 doses of IPTp-SP among pregnant women. METHODS:We conducted a cross-sectional study in 2017 among post-delivery women and health care workers from nine randomly-selected public health facilities in three Districts of Arusha Region. Probability proportional to size methodology was used to determine number of participants per facility. We used a structured questionnaire to collect socio-demographic and obstetric data, information on doses of SP received, and knowledge of SP for IPTp. Health care workers were interviewed about their knowledge for IPTp- SP and challenges encountered in its uptake and use. RESULTS:We interviewed 556 persons (median age 26?years, range 16-42?years) with the response rate of 99.3%. Of these, 484 (87.1%) had >?3 Antenatal Care (ANC) visits. A total of 402 (72.3%) were multigravida with 362 (65.1%) having given birth at least once. Of the 556 participants, 219 (39.4%) made their first ANC booking at ?3 doses of SP-IPTp. Factors associated with uptake of >?3 doses of IPTp-SP included having secondary or higher education [Adjusted Odds Ratio (AOR) =1.6, 95%CI 1.1-2.4], attending ?4 ANC visits [AOR?=?3.1, 95%CI 2.1-4.6], having first antenatal booking at ?3 doses of IPTp-SP. That is below the Tanzania national target of 80%. Making >?4 ANC visits, having secondary or higher education, making an early first ANC visit and having adequate knowledge on IPTp-SP promoted uptake of >?3 doses. Further qualitative studies are needed to explore factors that might contribute to low uptake of SP.

SUBMITTER: Mchwampaka WM 

PROVIDER: S-EPMC6880562 | BioStudies | 2019-01-01

REPOSITORIES: biostudies

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