Abstract:
INTRODUCTION : the World Health Organization (WHO) recommends that in malaria endemic areas with moderate to high transmission rates, pregnant
women presenting for antenatal clinic (ANC) should receive at least three doses of intermittent preventive treatment in pregnancy (IPTp) for malar ia
between the 16th and 36th weeks of pregnancy at intervals of 4 weeks between doses. Several challenges remain in effective implementation of IPTp
policy making the targeted coverage (80%) of the third doses of IPTp far from being achieved. The main objective of this study was to assess factors
associated with the uptake of IPTp among pregnant women attending ANCs in the Bamenda Health District. METHODS : to reach our objectives, we
carried out a cross-sectional study following informed consent with thirty-nine (39) healthcare workers (HCW) and four hundred (400) pregnant
women who were either in the third trimester of pregnancy or had recently given birth in any of thirty-six (36) health facilities (HF) within the
Bamenda Health District (BHD) from May to August 2014. All sites within the BHD were included. The participants were selected by simple random
sampling. The principal research instrument was a structured and pre-tested questionnaire that was designed to capture socio-demographic data
and data related to stage of pregnancy and knowledge about IPTp. Data was entered using Ms Excel and analysed using SPSS v20.0. Descriptive
statistics (frequencies and percentages) was used to report findings. We used Chi-Square test to compare the categorical variables (Fischer’s exact
test was used in cases were conditions for Chi-Square test were not met). RESULTS : uptake for at least one dose of IPTp was 95.3% (381/400) and
54.9% (209/400) had received all three doses, 15.5% (59/400) received only one dose and 4.8% (19/400) did not receive any of the doses of IPTp.
Knowledge about IPTp was associated with an increase uptake of IPTp (P<0.001). All health care providers were knowledgeable about the importance
and use of IPTp. However, 35.9% reported not receiving any training on IPTp. Among the health providers, 28.2% did not know when to start IPTp
and 43.59% did not know when to stop IPTp. Out of all the health care providers, 30.77% complained of medication (sulfadoxine-Pyrimethamine)
stock out and 84.62% practiced the policy of direct observed therapy. CONCLUSION : the uptake of the third dose of IPTp is poor in the Bamenda
Health District and this may be attributed to medication stock out and inadequacy of routine trainings for the health providers. The good practice
observed was that of direct observed therapy by HCWs. Patient knowledge about IPTp in our study was associated with better uptake of IPTp.
Encouraging education of pregnant women on the importance of IPTp, providing routine training to HCWs and promoting direct observation of
therapy may improve on IPTp uptake during pregnancy.
