Sarfo Jacob Owusu, Doe Patience Fakornam, Mireku Dickson Okoree
Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana.
Centre for Behaviour and Wellness Advocacy, Koforidua, Ghana.
Res Health Serv Reg. 2024 Dec 23;3(1):22. doi: 10.1007/s43999-024-00058-6.
Ghana adopted the policy on Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) in 2004. Notwithstanding the government's and other stakeholders' efforts in Ghana, optimal uptake (three or more doses of IPTp-SP) has slightly declined since 2016. The study examined the individual and community-level correlates of pregnant women who take optimal or none/partial doses (less than three doses) of IPTp-SP using the Ghana Malaria Indicator Survey (GMIS) 2019.
We conducted a secondary analysis of the GMIS 2019 data. Our analytical sample included 1,151 women aged 15-49 with their most recent birth in the last two years before the survey.
The overall uptake among participants was approximately 8.2% for none, 30.15% for 1-2 (partial), and 61.6% for 3 or more (optimal) doses of IPTp-SP. The level of uptake differs depending on the individual rather than community-level characteristics of pregnant women. Individual-level demographic factors- residents in Upper East (OR 3.0, 95% CI; 1.2-7.3) and Upper West (OR 5.3, 95% CI; 1.9-14.7) -and health-related factors-the four or more antenatal (ANC) visits (OR 3.3, 95% CI; 1.8-6.0) were associated with optimal IPTp-SP uptake among pregnant women in Ghana. However, late scheduling of the first ANC visit in the second trimester (OR 0.7, 95% CI; 0.5-1.0)- predicted less IPTp-SP uptake.
Few regions (Upper East and West) are doing better than the capital, Greater Accra Region, in terms of optimal uptake. Also, early scheduling of ANC in the first trimester and increased ANC attendance are key for increased uptake. There is a need for policy, interventions, and research on malaria prevention in pregnancy to improve the decline in uptake.
加纳于2004年采用了使用周效磺胺-乙胺嘧啶进行孕期疟疾间歇性预防治疗（IPTp-SP）的政策。尽管加纳政府和其他利益相关者做出了努力，但自2016年以来，最佳覆盖率（三剂或更多剂IPTp-SP）略有下降。本研究利用2019年加纳疟疾指标调查（GMIS），调查了服用最佳剂量或未服用/部分剂量（少于三剂）IPTp-SP的孕妇的个体和社区层面的相关因素。
我们对GMIS 2019年的数据进行了二次分析。我们的分析样本包括1151名年龄在15至49岁之间、在调查前两年内有过最近一次生育的女性。
参与者中，未服用IPTp-SP的总体覆盖率约为8.2%，服用1-2剂（部分剂量）的为30.15%，服用3剂或更多剂（最佳剂量）的为61.6%。覆盖率水平因孕妇的个体特征而非社区特征而异。个体层面的人口统计学因素——上东部地区（比值比3.0，95%置信区间；1.2-7.3）和上西部地区（比值比5.3，95%置信区间；1.9-14.7）的居民——以及与健康相关的因素——四次或更多次产前检查（比值比3.3，95%置信区间；1.8-6.0）——与加纳孕妇最佳IPTp-SP覆盖率相关。然而，孕中期首次产前检查安排较晚（比值比0.7，95%置信区间；0.5-1.0）——预示着IPTp-SP覆盖率较低。
就最佳覆盖率而言，少数地区（上东部和上西部）比首都大阿克拉地区表现更好。此外，孕早期尽早安排产前检查以及增加产前检查次数是提高覆盖率的关键。有必要针对孕期疟疾预防制定政策、采取干预措施并开展研究，以改善覆盖率下降的情况。
