Factors affecting the implementation of intermittent preventive treatment of malaria in pregnancy in Dar es Salaam health facilities.

Abstract

Background Tanzania adapted the World Health Organization (WHO) policy of giving two doses of Sulphadoxine- Pyrimethamine (SP) to pregnant women attending Antenatal clinics (ANCs) in order to control malaria in pregnancy. Implementation of IPT policy has been observed to face various challenges making the targeted coverage of 80% too far from being achieved. The main objective of this study was to identify factors affecting the uptake of Intermittent Preventive Treatment of Malaria among pregnant women attending ANCs in Dar-es Salaam region. Methodology A cross sectional study was carried out where interviewer guided questionnaires were administered to 302 pregnant women and 25 healthcare workers. The Reproductive and Child Health (RCH) cards of the pregnant women were also inspected for additional information. Focus Group Discussions (FGD) were conducted to the ANC staff and non participatory ANC observations were made using a standardized checklist. Results The IPT program in Dar es salaam public health facilities has successfully achieved higher coverage for both IPT 1 and IPT 2, (90% and 79.5% respectively).Gestation age appeared to have an influence on knowledge of pregnant women in IPT (p=0.04) and knowledge seem to have a significant relationship with IPT coverage (p= 0.03). Generally there was high knowledge among health care workers and availability of drug for IPT administration was good (92%), the probable reason for high coverage. Conclusion. The IPT program has successfully achieved higher coverage for both IPT 1 and IPT 2. Factors that were observed to influence coverage include knowledge of both healthcare workers and pregnant women, availability of SP and monitoring of IPT services. Knowledge of the pregnant women was found to be generally high and had an influence on the coverage of IPT.