Ogba Patricia, Baumann Andrea, Alabi Tunde, Archer Norm, Eniojukan Joshua, Ibhawoh Bonny, DiLiberto Deborah D
Global Health Office, Faculty of Health Sciences, McMaster University, Main St. W, Hamilton, Ontario, Canada.
Department of Sociology, University of Lagos, Akoka, Nigeria.
Malariaworld J. 2025 May 6;16:9. doi: 10.5281/zenodo.15351243. eCollection 2025.
Malaria remains a major global health challenge, disproportionately affecting pregnant women and children. In Nigeria, malaria in pregnancy contributes to 70.5% of maternal morbidity and 41.1% of maternal mortality. Recognising these risks, the World Health Organization recommends intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) as a key strategy for malaria in pregnancy prevention. However, despite its proven effectiveness, pregnant women's uptake of IPTp-SP remains unacceptably low. This study presents participant-driven recommendations to enhance IPTp-SP uptake, structured within the socio-ecological framework.
This study employed an exploratory descriptive qualitative approach to examine the community-level contextual factors influencing IPTp-SP uptake. Data were collected from 53 participants in two communities in Bayelsa, Nigeria. Individual interviews were conducted with 17 key stakeholders (spouses, mothers-in-law, religious leaders, community leaders, and traditional birth attendants) and 6 focus group discussions with 36 pregnant women. Data management and coding were conducted using NVivo 14 QSR International software, following an inductive-deductive thematic analysis approach.
Participants proposed multi-level interventions to address barriers to IPTp-SP uptake at the individual, interpersonal, community, and healthcare system levels. Key recommendations include: Community-wide education campaigns to raise awareness of IPTp-SP's benefits; comprehensive training for healthcare providers to enhance their knowledge and prescription of IPTp-SP; integration of traditional birth attendants into the formal healthcare system; community-level distribution of IPTp-SP to improve access for pregnant women who do not attend antenatal care; government intervention to ensure the functionality of health centers; addressing workforce shortages, and guaranteeing a consistent supply of IPTp-SP.
These evidence-based, participant-driven recommendations offer a holistic and scalable strategy to improve pregnant women's uptake of IPTp-SP in Nigeria and other malaria-endemic regions. Implementing these recommendations can strengthen malaria prevention efforts, improve maternal and child health outcomes, and support broader public health initiatives.
疟疾仍然是一项重大的全球卫生挑战，对孕妇和儿童的影响尤为严重。在尼日利亚，孕期疟疾导致70.5%的孕产妇发病和41.1%的孕产妇死亡。认识到这些风险后，世界卫生组织建议使用磺胺多辛-乙胺嘧啶进行间歇性预防治疗（IPTp-SP），作为预防孕期疟疾的关键策略。然而，尽管其有效性已得到证实，但孕妇对IPTp-SP的接受率仍然低得令人无法接受。本研究提出了由参与者驱动的建议，以提高IPTp-SP的接受率，并在社会生态框架内进行构建。
本研究采用探索性描述性定性方法，以检查影响IPTp-SP接受率的社区层面背景因素。数据收集自尼日利亚巴耶尔萨州两个社区的53名参与者。对17名关键利益相关者（配偶、岳母、宗教领袖、社区领袖和传统助产士）进行了个人访谈，并与36名孕妇进行了6次焦点小组讨论。使用NVivo 14 QSR国际软件进行数据管理和编码，采用归纳-演绎主题分析方法。
参与者提出了多层次干预措施，以解决个人、人际、社区和医疗系统层面IPTp-SP接受率的障碍。主要建议包括：开展全社区教育活动，提高对IPTp-SP益处的认识；对医疗服务提供者进行全面培训，以增强他们对IPTp-SP的知识和处方开具能力；将传统助产士纳入正规医疗系统；在社区层面分发IPTp-SP，以改善未参加产前护理的孕妇的可及性；政府进行干预，以确保卫生中心的功能；解决劳动力短缺问题，并保证IPTp-SP的持续供应。
这些基于证据、由参与者驱动的建议提供了一个全面且可扩展的策略，以提高尼日利亚和其他疟疾流行地区孕妇对IPTp-SP的接受率。实施这些建议可以加强疟疾预防工作，改善母婴健康结果，并支持更广泛的公共卫生举措。
