Abstract:

Malaria is a vector borne protozoa disease that is endemic in Nigeria and continues to present significant public health challenge to the Nigerian government. Pregnant women are especially vulnerable to malaria infection due to their compromised immunity. Malaria contributes significantly to poor pregnancy outcomes like low birth weight, premature delivery, still birth, spontaneous abortion and neonatal death.

The use of IPTp-SP has been proven to be a safe, cheap and effective means to prevent malaria and its consequences among pregnant women. Consequently, pregnant women are expected to receive a minimum of three doses of IPTp-SP beginning from the 13^th week of pregnancy. In spite of this, uptake of IPTp-SP by pregnant women still remains low in Nigeria.

This research investigated the demographic and behavioural factors that were associated with uptake of at least three doses of IPTp-SP among women who had a live birth in the two years preceding the survey. The study was quantitative in design and used cross sectional data that included 3205 women from Akwa Ibom, Kebbi and Nasarawa states.

Findings from this study suggest that ANC attendance is the most important factor associated with uptake of a minimum of three doses of IPTp-SP (IPTp-SP3). This might not be unconnected to the IPTp-SP strategy being largely a facility based intervention. Household wealth index exhibited a marginally significant relation with uptake of IPTp-SP3. After adjusting for cluster level effects and other potential confounders, a woman’s decision making autonomy and state where she was resident were found to be significantly associated with uptake of IPTp-SP3. An unexpected but logical finding was the inverse relationship between regular use of bed net and uptake of IPTp-SP3. This finding has implication for how bed net use is presented to pregnant women.

Results from this study suggests that, improved access to ANC services, improved women’s autonomy , and educating pregnant women that regular bed net use does not preclude the need for IPTp-SP utilization could go a long way in improving uptake of IPTp-SP among pregnant women in Nigeria.

Keywords: Malaria, Pregnancy, Ante natal care, IPTP-SP, Behaviour, Nigeria.

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