Adherence to sulfadoxine-pyrimethamine five-dose policy among pregnant women in an urban slum in Ghana: a mixed-methods study.

IF 2.4 3区 医学 Q3 INFECTIOUS DISEASES Malaria Journal Pub Date : 2024-10-17 DOI:10.1186/s12936-024-05127-2
Hainau Iddrisu, Emmanuel Ayitey Tagoe, Harriet Affran Bonful
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Abstract

Background: Malaria in pregnancy (MiP) is a public health concern especially for pregnant women living in slums. The World Health Organization recommends at least three doses of Sulfadoxine-Pyrimethamine (SP) to prevent MiP. In Ghana, it is recommended that pregnant women receive a minimum of five doses of the medication. This study sought to determine the level of adherence to IPT5 policy and factors associated with adherence among pregnant women in a slum community in Ghana.

Methods: This was a cross-sectional study involving 232 nursing mothers and four healthcare workers at the St. Martin's Memorial Hospital, Sukura, Ghana. Sociodemographic characteristics of nursing mothers were obtained using an interview-administered questionnaire. Data on the number of SP doses and other obstetrics characteristics were collected by reviewing the antenatal record books. To obtain information about healthcare and health system factors associated with adherence to the five-dose policy, four healthcare providers were interviewed. A data extraction form was used to obtain information about the availability of SP at the facility.

Results: The level of adherence to IPT5 was 8.6% (20/232) (95% CI 5.0-12.3) among the participants. Only 8.4% of the participants received their first dose at 16 weeks. Respondents who began ANC in the second trimester were 81% less likely to adhere to IPT5 than those who began in the first trimester (aOR = 0.19, 95% CI 90.01-0.65, p < 0.008). Healthcare provider and health system factors that influence IPT5 uptake include healthcare providers' knowledge of IPTp-SP guidelines, the practice of Directly Observed Therapy, education of pregnant women, training of healthcare providers, and availability of water. SP was available at the facility during the period of review.

Conclusion: Adherence to the IPTp-SP five-dose policy was suboptimal. Pregnant women who started ANC early were more likely to adhere to the policy. Provider knowledge, DOT practice, training, education of pregnant women and water availability were also found to influence adherence. Encouraging early ANC visits and providing healthcare workers with necessary training can substantially improve adherence in slum areas.

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加纳城市贫民窟孕妇对磺胺乙胺嘧啶五剂量政策的遵守情况:一项混合方法研究。
背景:妊娠期疟疾(MiP)是一个公共卫生问题,尤其是对生活在贫民窟的孕妇而言。世界卫生组织建议至少服用三剂磺胺乙胺嘧啶(SP)来预防妊娠期疟疾。在加纳,建议孕妇至少服药五次。本研究旨在确定加纳一个贫民窟社区的孕妇遵守IPT5政策的程度以及与遵守该政策相关的因素:这是一项横断面研究,涉及加纳苏库拉圣马丁纪念医院的 232 名哺乳期母亲和 4 名医护人员。研究人员通过访谈问卷了解了哺乳期母亲的社会人口学特征。通过查阅产前记录簿,收集了有关 SP 剂量和其他产科特征的数据。为了解与遵守五剂政策相关的医疗保健和医疗系统因素,对四名医疗保健提供者进行了访谈。数据提取表用于获取有关医疗机构是否提供 SP 的信息:参加者中坚持 IPT5 的比例为 8.6%(20/232)(95% CI 5.0-12.3)。只有 8.4% 的参与者在 16 周时接受了第一剂治疗。在妊娠后三个月开始接受产前保健的受访者坚持 IPT5 的可能性比在妊娠前三个月开始接受产前保健的受访者低 81%(aOR = 0.19,95% CI 90.01-0.65,p 结论:在妊娠后三个月开始接受产前保健的受访者坚持 IPT5 的可能性比在妊娠前三个月开始接受产前保健的受访者低 81%:坚持 IPTp-SP 五剂政策的情况并不理想。早期开始产前检查的孕妇更有可能遵守该政策。研究还发现,医护人员的知识、DOT实践、培训、孕妇教育和水的供应也会影响政策的遵守情况。鼓励尽早进行产前检查,并为医护人员提供必要的培训,可大大提高贫民窟地区的坚持率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Malaria Journal
Malaria Journal 医学-寄生虫学
CiteScore
5.10
自引率
23.30%
发文量
334
审稿时长
2-4 weeks
期刊介绍: Malaria Journal is aimed at the scientific community interested in malaria in its broadest sense. It is the only journal that publishes exclusively articles on malaria and, as such, it aims to bring together knowledge from the different specialities involved in this very broad discipline, from the bench to the bedside and to the field.
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