Determinants of Uptake of Intermittent Preventive Treatment for Malaria With Sulfadoxine Pyrimethamine in Pregnancy: A Cross-Sectional Study in the Sekondi-Takoradi Metropolis of Ghana

Abstract BackgroundGhana malaria control programme recommends the uptake of five doses of SP during pregnancy following the review of the WHO recommendations in 2012. The uptake of higher doses of SP since the implementation of the new policy in 2016, has been low across the country. The current study determined factors that can be improved to increase uptake of IPTp-SP in malaria endemic regions. MethodsA descriptive cross-sectional study was carried out among women who had just delivered in selected health facilities in the Sekondi-Takoradi Metropolis of Ghana. Participants were enrolled from the lying-in wards of the study facilities after delivery. Data including time of initiating ANC, number of visits, time of first dose of SP and number of doses were collected. ANC books were also reviewed. Logistic and multinomial logistic regression analyses were done to determine respondent factors associated with uptake of IPTp-SP using Stata 15. ResultsOut of the 496 mothers who participated in the study, 370 (74.60%) initiated ANC during the first trimester, 123 (24.80%) during the second, with only three (0.60%) starting during the third trimester. Majority (463/496, 93.35%) made > 4 visits. Uptake of at least one dose of SP was 98.79% (490/496), ≥ 2 doses was 92.75 (460/496), ≥ 3 doses was 80.65% (400/496) and ≥ 4 doses was 40.32% (200/496). Uptake of IPTp 5 was very low (6.65%, 33/490). A unit increase of one ANC visit was associated with 20% higher odds of receiving 3-4 doses of SP with respect to receiving 1-2 doses (p<0.001). The probability of receiving 5 or more doses of SP with respect to 1-2 doses was 26% higher with a unit increase of one ANC visit. Conclusion Uptake of 3-4 doses and ≥ 5 doses of SP were associated with making more ANC visits. Encouraging and motivating expectant mothers to make more ANC visits can improve uptake of ≥ 5 doses of SP.