Abstract

Jacob Kwasi, David Nyagah and Abdul Nyamweya

Intermittent Preventive Treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine is a key intervention for malaria prevention. Bungoma East District falls within the malaria-endemic zone of Kenya, with an infection risk class of 20%, or higher. Even though malaria accounts for about 41% of maternal deaths in the District, uptake of the second dose (IPTp2) remains below the Roll Back Malaria target. Perceptions about a disease and prophylactic interventions are likely to influence health behavior. This study set to determine women’s perceptions influencing IPTp2 uptake to support the need for appropriate interventions to strengthen IPTp programs in malaria-endemic countries. We applied the cross-sectional survey design and sourced primary data from 278 women who were at the twenty-fourth week, or more of gestation, aged between 15 and 49 years, had not experienced malaria during the pregnancy, and were not on cotrimoxazole prophylaxis. Analysis techniques included independent samples t-test, cross-tabulations with Chi Square statistic and binary logistic regression. Women believing that they were ‘very susceptible’ to malaria infection had about 2.3 times the odds of taking IPTp2+ as those indicating that they were ‘not susceptible’ (β = 0·813, SE = 0·239, 95% CI = 1·41- 3·60). Women perceiving that SP tablets were ‘very useful’ had 1·7 times the odds of taking IPTp2+ as those believing that SP tablets were ‘not useful’ (β = 0·552, SE = 0·139, 95% CI = 1·32-2·28). Women perceiving that SP tablets were ‘very safe’ for use during pregnancy had about 25·4 times the odds of taking IPTp2+ as those believing that SP tablets were ‘not safe’ (β = 3·235, SE = 0·63, 95% CI = 21·54- 29·40). The stronger the conviction about personal susceptibility to infection, as well as usefulness and safety of SP tablets, the higher the odds of IPTp2+ uptake. Strengthening health education interventions at the antenatal clinics is likely to re-orient negative perceptions, dispel misconceptions, and clear the way for IPTp2+ uptake.