An evaluation of intermittent preventive treatment of malaria during pregnancy in four Health Centres in Lusaka District

Abstract

Background: Malaria is an important health problem, and pregnant women and the foetus are not immune from its effects. There are numerous complications of malaria in pregnancy. However, steps to mitigate its effects like use of sulfadoxine–pyrimethamine in pregnancy have been implemented and maternal access is yet to be assessed especially in the City of Lusaka. Aim: The aim of this study was to evaluate the implementation of IPTp Malaria Prevention during Pregnancy within the selected health centres in Lusaka District. Methodology: A mixed methods study design utilising a survey questionnaire focus group discussions (FGD) and in-depth interviews (IDI) was done. Data were collected using qualitative survey questionnaire, key informant interviews (KII) and focus group discussions (FGD).Four officer in-charges of health centres and 522 mothers (from George compound, Kalingalinga, Kanyama and Chilenje) were purposefully and randomly selected respectively. Qualitative data was analysed using modified grounded theory technique by linking it with Husserlian descriptive and Gadamerian hermeneutic phenomenology. As for the quantitative data, the data were initially entered into Epi Info version 6.0 (CDC, Atlanta, GA, USA), cleaned and transferred to SPSS version 18 for analysis. Descriptive analyses were performed to determine antimalarial access. Results: The level of administration of antimalarial regimen in the four health centres was very low across and within the trimesters. Drug availability was extremely low. There were facilitators and challenges linked to the IPTp program in the four health centres. There were seven challenges that were identified and these included: Fear of complications taking drugs, large population, expenditure or cost, lack of regular drug availability, staff shortage, low stocks, and huge workloads. As for facilitators, five were identified and these were: mothers had no problems taking drugs, there were cues to drug usage, and mothers recognised perceived threats, benefits and seriousness of the illness vis-a-vis drugs. Conclusion: Prevention of malaria in pregnancy through use of IPTp was uncommonly reported in this study population. Overall, nearly every woman did not receive IPTp. These findings call for considering the use of community-based approaches to distribute IPT; and resource persons need to be trained, facilitated and linked to the health units to get IPTp basic supplies.