Factors affecting utilization of intermittent preventive treatment of malaria in pregnancy in bukanga health sub district - isingiro district- Uganda.

Abstract

Background: Intermittent preventive treatment (IPTp) using Sulphadoxine/Pyrimethamine is a strategy recommended for preventing malaria in Pregnancy worldwide (WHO 2014 ), however utilisation of IPTp services was low, (49% & 42.2%) in Isingiro district and Bukanga HSD respectively, far below national target of 80%. This study assessed factors affecting utilization of IPTp services in Bukanga HSD – Isingiro District. Methods: Study was a community based cross sectional study. A total of 413 mothers aged between 15-49 years, who delivered in the last 12months were sampled by simple random sampling and interviewed at household, about 12 KIs (Health workers involved in provision of MCH services) were also purposively sampled and interviewed. The association between outcome variable was tested using Pearson’s Chi-Square(x²) and odds ratio. And P value ≤0.05 was considered to be significant Results: Utilisation of IPTp-1 was at 44.55%, IPTp-2 at 25.67% and IPTp-3 at 23.00%. IPTp-2 and IPTp-3 utilization is very low compared to the recommended national target of 80%. Independent factors associated with IPTp utilization included High monthly earnings (OR= 2.0, 95% C I=1.0-3.3) having antenatal cards to remind them for ANC and IPTp visits (OR=0.6,95%CI=0.3-0.9), fear of malaria complications (OR=0.6; 95%CI=0.3-0.9) Means of transport used to health centers for ANC and IPTp services (Motorized vs Non motorized) (OR=2.0;95%CI=1.0-3.1).Preferred place to swallow SP (OR=0.5,95%CI=.0.2-0.9) (Clinic vs Home).Qualitative data showed understaffing in most health centers. Sulphadoxine/Pyrimethamine was not swallowed under observation, because Mugs and boiled water were sometimes not provided. Conclusion: IPTp-2 and IPTp-3 utilisation among pregnant mothers in Bukanga Health Sub District was very low compared to the national target of 80%. There is need to intensify health education on benefits of IPTp services taking an advantage of antenatal care attendance, recruit more health workers especially mid wives to eliminate understaffing in antenatal clinics, engage mothers in high paying projects to raise monthly earnings, and carry out more studies about IPTp in Bukanga health Sub district to strengthen these findings