Utilization Drop-Out of Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine among Pregnant Women in North Western Ghana
Science Journal of Public Health
Volume 2, Issue 3, May 2014, Pages: 156-164
Received: Mar. 6, 2014;
Accepted: Apr. 16, 2014;
Published: Apr. 20, 2014
Views 2542 Downloads 132
Anthony Chiaraah, Department of Economics and Entrepreneurship Development, University for Development Studies, Wa, Ghana
Ebenezer Owusu-Sekyere, Department of Development Studies, University for Development Studies, Wa, Ghana
Although studies have shown the efficacy of Intermittent Preventive Treatment (IPT) with Sulfadoxine-pyrimethamine (SP) as a chemo ‘prophylaxis’ for malaria during pregnancy, the dose completion rate is still low in many communities in Ghana. Since the implementation of the IPT with SP policy on pilot basis in some districts and the scaling-up of the policy in other districts of the Upper West Region (UWR), available statistics reveal a high drop-out rate in the second dose. This study assessed various factors that contribute to the low utilization and completion rate of SP, and elicit suggestion for the improvement of the implementation of the policy. This anthropological study was conducted in the Wa municipality of Ghana. A total of six FGDs were held, 4 with pregnant women and 2 with post natal mothers using a semi structured questionnaire. In addition 17 key informant interviews of health service providers of different categories were conducted and additional information on records also reviewed. The results revealed that there was high level of awareness and knowledge of SP as an intervention for malaria prevention during pregnancy. However, negative factors like staff attitude towards clients, mix understanding of correct doses and interval, poor quality of services, and distance to health facilities, lack of proper education as well as culture hindered pregnant women from taking the drug leading to high dropout rate. The study posits that the trend is likely to continue unless a clear policy governing the IPT is efficiently implemented.
Utilization Drop-Out of Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine among Pregnant Women in North Western Ghana, Science Journal of Public Health.
Vol. 2, No. 3,
2014, pp. 156-164.
A.Mbonye, S.Neema, P. Magnusson, (.2005) Perceptions on use of sulfadoxin-Pyremithemine in pregnancy and the policy implications for malaria control in Uganda. Health Policy, Vol.77 279-289.
Ministry of Health (2004) Anti-malaria Drug policy for Ghana.
D’Alessandro et al. (1995) A comparison of the efficacy of Insecticide-treated nets and untreated nets in preventing malaria in Gambia children. Transactions Royal society of Tropical Medicine and Hygiene. 89: 596-8
Dolan G, ter Kuile FO, Jacoutot V et al. (1993). Bed nets for the prevention of malaria and anemia in pregnancy. Transactions Royal society of Tropical Medicine and Hygiene 87: 620-6
Ghana Statistical Service. (2003) Demographic Health Survey. Ghana.
Ghana Health Service, (2005) Upper West Regional Health Report;.Ghana
Ghana Health Service/National Malaria Control Programme;(2005) Intermitted Preventive Treatment (IPT) of Malaria in pregnancy; Training Manual for Health Providers:
Heggenhougen, H.K., Hackenthal, V.& Vivek, P.(2003) The Behaviour and Social Aspects of Malaria Control: An introduction and Annotate Biography. Special Programme for Research & Training in Tropical Disease.
Jenny Hill & Peter Kazember; (2006) Reaching the Abuja target for Intermittent Preventive Treatment of Malaria in Pregnancyin African women: a review of progress and operational challenges. Liverpool School of Tropical Medicine, 11:409-418.
Jirapa/Lambussie (2007) Evaluation of Intermittent Preventive Treatment. District health management team ( Yet to be disseminated) Ghana
Kassoum et al (2005). Comparison of Intermittent Treatment with Chemoprophylaxis for the prevention of Malaria during pregnancy in Mali. The journal of Infectious Diseases, Vol.191, P 109-116.
Kaye, D., (2000). Quality of midwifery care in Soroti district, Uganda. East Africa Medical journal 77,558-61.
Ndyomugyenyi, R.,Neema, S., Magnussen, P.,( 1998). The use formal and informal services for Antenatal care and malaria treatment in rural Uganda. Health pol. Plan. 13, 94-104.
RBM.WHO.INT http://mosquito.who.int Viewed on 22/ 03/ 07
Rogerson, et al (1997) Intermittent Sulfadoxine-pyremithemine in pregnancy: Effectiveness against malaria morbidity in Blantyre, Malawi in 1997 – 99. Trans.Roy.Soc. Trop.Med.Hgy. 549-553.
Sachs J, Foreword (2003).Reducing malaria’s burden. Evidence of effectiveness for decision makers. Global Health Council Technical Report.
Shulman CE. Malaria in pregnancy: (1999) its relevance to safemotherhood programme on the outcome of pregnancy. Annals of tropical medicine and parasitology
Sirima, S.B et al. (2003) Failure of chloroquine chemoprophylaxis programme to adequately prevent malaria during pregnancy in Koupela district, Burkina Faso. Clinical infectious diseases, 36 (11):1374 -1382.
Snow, RW, Rowan K.M, Lindsay S W, Green B M.(1988). A trail of bednets(mosquito) as a malaria control strategy in a rural area of the Gambia, West Africa. Transactions Royal Society of Tropical Medicine and hygiene, 82: 212-5
Steketee et al. (1999) Impairment of a pregnant woman’s acquired ability to limit Plasmodium falciparum by infection with human immunodeficiency virus type-1.American journal of tropical medicine and hygiene,,55(1suppl.): 42-49.
Steketee RW et al. (2001) The burden of malaria in Pregnancy malaria-endemic areas. American journal of tropical medicine and hygiene, 64) 28:35
Van Eijk, J. G Ayisi, F. O. (2004). Effectiveness of Intermittent Preventive Treatment with Sulphadoxine –Pyrimethemamine for control of malaria in pregnancy in western Kenya: a hospital –based study. Trop. Med. Int.Health. Page 351.
Wa Municipal (2006) Health directorate; annual report; Ghana
WHO.(2004)The African summit on Roll Back Malaria, Abuja, Nigeria.200.,17(WHO/CDC/RBM
WHO. (2010) A strategic framework for malaria prevention and control during pregnancy in the African region. Brazzaville, World Health Organizatio; AFR/MAL/04/01.
WHO.(2000) Communicable diseases cluster. Severe falciparum malaria. Trans R Soc Trop Med Hgyg .