DOI: https://njcpt.com.ng/101.1.2.35
Abstract
Background: Malaria in pregnancy has been associated with adverse outcomes for the mother, foetus and newborn, including maternal anaemia, low birth weight and neonatal mortality. Intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) is one of the key interventions recommended by the World Health Organization and adopted by many countries in malaria-endemic regions for the prevention and control of malaria in pregnancy. The WHO recommends that pregnant women receive sulphadoxine-pyrimethamine monthly during every antenatal care from the second trimester until delivery. This reviewed guideline by WHO was adopted by the Nigerian National Malaria Control Program in 2017.
Objectives: The study assessed coverage rates and missed opportunities for IPTp-SP administration at antenatal clinics (ANC).
Methods: This retrospective analysis was conducted over a month at the antenatal clinic units of two secondary hospitals in two different geopolitical zones of Nigeria. Obstetric data of all pregnant women were collected from the ANC registers of the two hospitals for all entries in 2013 that were up to 36 weeks of gestation and above.
Results: Data from 2134 pregnant women with gestational age up to 36 weeks were abstracted from the ANC registers of the two facilities. Within this population, the coverage rates of one-SP, two-SP and three-SP doses were 15.7% (335), 65.7% (1401) and 0.6% (13), respectively, while 18% (385) had no record of receiving any dose of SP. The percentage of pregnant women with up to four ANC visits was 72.9% (1546), while 8% (170) recorded their first ANC visit at a gestational age of > 36 weeks. The prevalence of missed opportunities for administration of at least 2-dose IPTp-SP among women with up to four ANC visits was 23.9% (370).
Conclusion: A moderate coverage rate of two-dose IPTp-SP was recorded, below the recommended target level of up to 100% rates in ANCs. There was also poor implementation of IPTp-SP intervention at the ANCs, leading to missed opportunities despite a substantial percentage of pregnant women that had up to the WHO-recommended four ANC visits before delivery.
Keywords: coverage rates, missed opportunities, IPTp-SP