Access to and use of preventive intermittent treatment for Malaria during pregnancy: A qualitative study in the Chókwè district, Southern Mozambique.
Adult
Antimalarials
/ administration & dosage
Communication
Drug Combinations
Female
Health Knowledge, Attitudes, Practice
Health Personnel
/ organization & administration
Health Services Accessibility
/ organization & administration
Humans
Malaria
/ prevention & control
Mozambique
Patient Acceptance of Health Care
/ psychology
Pregnancy
Pregnancy Complications, Parasitic
/ prevention & control
Prenatal Care
/ psychology
Pyrimethamine
/ administration & dosage
Qualitative Research
Referral and Consultation
/ organization & administration
Rural Health Services
/ organization & administration
Rural Population
Sulfadoxine
/ administration & dosage
Young Adult
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
22
08
2018
accepted:
08
01
2019
entrez:
25
1
2019
pubmed:
25
1
2019
medline:
29
9
2019
Statut:
epublish
Résumé
Malaria remains a significant health problem in Mozambique, particularly in the case of pregnant women and children less than five years old. Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) is recommended for preventing malaria in pregnancy (MiP). Despite the widespread use and cost-effectiveness of IPTp-SP, coverage remains low. In this study, we explored factors limiting access to and use of IPTp-SP in a rural part of Mozambique. We performed a qualitative study using semi-structured interviews to collect data from 46 pregnant women and four health workers in Chókwè, a rural area of southern Mozambique. Data were transcribed, translated where appropriate, manually coded, and the content analyzed according to key themes. The women interviewed were not aware of the risks of MiP or the benefits of its prevention. Delays in accessing antenatal care, irregular attendance of visits, and insufficient time for proper antenatal care counselling by health workers were driving factors for inadequate IPTp delivery. Pregnant women face substantial barriers in terms of optimal IPTp-SP uptake. Health system barriers and poor awareness of the risks and consequences of MiP and of the measures available for its prevention were identified as the main factors influencing access to and use of IPTp-SP. Implementation of MiP prevention strategies must be improved through intensive community health education and increased access to other sources of information. Better communication between health workers and ANC clients and better knowledge of national ANC and IPTp policies are important.
Sections du résumé
BACKGROUND
Malaria remains a significant health problem in Mozambique, particularly in the case of pregnant women and children less than five years old. Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) is recommended for preventing malaria in pregnancy (MiP). Despite the widespread use and cost-effectiveness of IPTp-SP, coverage remains low. In this study, we explored factors limiting access to and use of IPTp-SP in a rural part of Mozambique.
METHODS AND FINDINGS
We performed a qualitative study using semi-structured interviews to collect data from 46 pregnant women and four health workers in Chókwè, a rural area of southern Mozambique. Data were transcribed, translated where appropriate, manually coded, and the content analyzed according to key themes. The women interviewed were not aware of the risks of MiP or the benefits of its prevention. Delays in accessing antenatal care, irregular attendance of visits, and insufficient time for proper antenatal care counselling by health workers were driving factors for inadequate IPTp delivery.
CONCLUSIONS
Pregnant women face substantial barriers in terms of optimal IPTp-SP uptake. Health system barriers and poor awareness of the risks and consequences of MiP and of the measures available for its prevention were identified as the main factors influencing access to and use of IPTp-SP. Implementation of MiP prevention strategies must be improved through intensive community health education and increased access to other sources of information. Better communication between health workers and ANC clients and better knowledge of national ANC and IPTp policies are important.
Identifiants
pubmed: 30677039
doi: 10.1371/journal.pone.0203740
pii: PONE-D-18-24709
pmc: PMC6345468
doi:
Substances chimiques
Antimalarials
0
Drug Combinations
0
fanasil, pyrimethamine drug combination
37338-39-9
Sulfadoxine
88463U4SM5
Pyrimethamine
Z3614QOX8W
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0203740Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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