Level and factors associated with optimal uptake of intermittent preventive treatment for malaria in pregnancy at private not for profit health facilities in Kasese District

Abstract

Background: Malaria in pregnancy poses a high risk of poor maternal and neonatal outcomes and WHO recommends IPTp. However, its uptake has remained sub-optimal among mothers who attend ANC at private not for profit health facilities. Objectives: To determine the level and factors associated with uptake IPTp at private not-for-profit (PNFP) health facilities in Kasese District, Uganda. Methods: A cross-sectional study involving 396 postpartum mothers in the postnatal wards of 8 PNFP health facilities in Kasese district was conducted in September 2022. One hospital and 2 HC IVs were purposively selected and 5 HC IIIs selected randomly. Mothers were consecutively selected and Interviewer administered semi-Structured questionnaires were used to collect the data. Data were entered in epi-data version 3.1, cleaned, and analyzed using STATA version 14. Descriptive statistics were used to summarize the continuous and categorical data. Data were adjusted for clustering & modified poison regression was used to determine associations between the factors and the outcome. Results: Level of optimal uptake of IPTp was 51.5% (46.6-56.4). Being married (aPR=1.35, 95% CI=1.06-1.7, p=0.014), attending ANC more than 4 Visits (aPR=1.29, 95%CI=1.09-1.54, p<0.001), positively influence optimal uptake while not taking IPTp at recommended time intervals (aPR =0.49, 95%CI= 0.39-0.62 p<0.001) and mothers paying for IPTp drugs themselves (aPR =0.74, 95%CI=0.57-0.97, p=0.031) negatively influence optimal uptake. Conclusion: This moderate uptake of IPTp among pregnant mothers suggests insufficient protection of pregnant mothers against malaria. Efforts to improve ANC attendance, taking IPTp at recommended time intervals, not paying for ITPp drugs, and marital status should be intensified.