A study on factors influencing utilization of intermittent presumptive treatment of malaria(IPTp) services by pregnant women in Sesheke District of Zambia
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Intermittent presumptive treatment of malaria in pregnancy (IPTp) is one of the recommended interventions by World Health Organization to mitigate the impact of malaria in pregnancy in malaria stable transmission zones such as Sub Saharan regions so as to ensure the best outcome for both the mother and her unborn child. In line with the Zambian policy on malaria control, Sesheke district started implementing IPTp in the year 2003 as one of the methods to combat malaria in pregnancy. Despite the availability of IPTp services in all the health facilities in Sesheke district, the uptake of IPTp is still very low especially for the second and third IPTp doses (fansidar). The main purpose of the study was to identify the factors influencing utilization of IPTp services by pregnant women in Sesheke District. The study was a cross sectional,non-intervention descriptive type conducted in Sesheke district in Western province of Zambia. Information was collected from 403 women and 16 health center in charges using two different semi structured interview schedules. Two focus group discussions were also conducted in two different areas. Stock control cards were also checked in order to determine the availability of fansidar in the eight selected health centers during the year 2012. In order to ensure that the findings were valid, statistical significant was set at p<0.05 The study found that only a total of 121 out of 403 women (30%) interviewed took all the three recommended doses of IPTp. 287 (71.2%) took at least the first dose, while 228(56.6%) took at least the second dose and 116 (28.8%) of them did not take any. Factors influencing IPTp utilization included; educational status of a woman (p = 0.032), knowledge level of a woman about IPTp services (p value 0.021), timing of first ANC (p = 0.014), number of times a woman attends ANC (p = 0.001). Fourty eight point nine percent of the women had good knowledge level about IPTp services, 18.9% of the women had fair knowledge and 32.2% had poor knowledge. The Odds ratio for good knowledge level was 2.952. This shows that women who had good knowledge level were 2.952 times more likely to complete the recommended IPTp doses. Stock levels of fansidar were 100% in six out of eight health centers. The reason for the stock out was due to malaria outbreak which led to the consumption of fansidar reserved for IPTp service. The most common challenge health providers faced while providing IPTp services was found to be lack of transport to enable them reach women in far and hard to reach areas and inability to conduct adequate outreach activities as planned due to lack of resources in form of allowances.
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