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Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Accessibility, availability and utilisation of malaria interventions among women of reproductive age in Kilosa district in central Tanzania

Authors: Susan F Rumisha, Maria M Zinga, Carolyn A Fahey, Dorothy Wei, Veneranda M Bwana, Malongo RS Mlozi, Elizabeth H Shayo, Robert C Malima, Benjamin K Mayala, Grades Stanley, Tabitha Mlacha, Leonard EG Mboera

Published in: BMC Health Services Research | Issue 1/2014

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Abstract

Background

Universal access to and utilization of malaria prevention measures is defined as every person at malaria risk sleeping under a quality insecticide-treated mosquito net (ITN) and every pregnant woman at risk receiving at least two doses of sulfadoxine-pyrimethamine (SP). This study aimed to determine factors affecting accessibility, availability and utilisation of malaria interventions among women of reproductive age in Kilosa district in central Tanzania.

Methods

Women of reproductive age with children <5 years old or those who had been pregnant during the past 5 years were included in the study. A structured questionnaire was used to seek information on malaria knowledge, accessibility and utilization of malaria interventions during pregnancy.

Results

A total of 297 women (mean age=29±6.8 years) were involved. Seventy percent of the women had attained primary school education. About a quarter of women had two children of <5 years while over 58% had ≥3 children. Most (71.4%) women had medium general knowledge on malaria while only eight percent of them had good knowledge on malaria in pregnancy. A significant proportion of women were not aware of the reasons for taking SP during pregnancy (35%), timing for SP (18%), and the effect of malaria on pregnancy (45.8%). Timing for first dose of SP for intermittent preventive treatment in pregnancy (IPTp) was 1-3 months (28.4%) and 4-6 months (36.8%). Some 78.1% were provided with SP under supervision of the health provider. Knowledge on malaria in pregnancy had a significant association with levels of education (p=0.024). Ninety-eight percent had an ITN, mostly (87.1%) received free from the government. All women attended the ANC during their last pregnancy. The coverage of IPT1 was 53.5% and IPTp2 was 41.1%. The proportion of women making more ANC visits decreased with increasing parity.

Conclusion

This study showed that the knowledge of the pregnant women on malaria in pregnancy and IPTp was average and is likely to have an impact on the low IPTp coverage. Campaigns that provide educational massages on the risk of malaria during pregnancy and the usefulness of IPTp need to be emphasised.
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Literature
1.
go back to reference De Beaudrap P, Turyakira E, White LJ, Nabasumba C, Tumwebaze B, Muehlenbaachs A, Guérin PJ, Boum Y, McGready R, Piola P: Impact of malaria during pregnancy on pregnancy outcomes in a Ugandan prospective cohort with intensive malaria screening and prompt treatment. Malaria J. 2013, 12: 139-10.1186/1475-2875-12-139.CrossRef De Beaudrap P, Turyakira E, White LJ, Nabasumba C, Tumwebaze B, Muehlenbaachs A, Guérin PJ, Boum Y, McGready R, Piola P: Impact of malaria during pregnancy on pregnancy outcomes in a Ugandan prospective cohort with intensive malaria screening and prompt treatment. Malaria J. 2013, 12: 139-10.1186/1475-2875-12-139.CrossRef
2.
go back to reference Teplin SW, Burchinal M, Johnson-Martin N, Humphry RA, Kraybill EN: Neurodevelopmental, health, and growth status at age 6 years of children with birth weights less than 1001 grams. J Pediat. 1991, 1991 (118): 768-777.CrossRef Teplin SW, Burchinal M, Johnson-Martin N, Humphry RA, Kraybill EN: Neurodevelopmental, health, and growth status at age 6 years of children with birth weights less than 1001 grams. J Pediat. 1991, 1991 (118): 768-777.CrossRef
3.
go back to reference Steketee RW, Wirima JJ, Hightower AW, Slutsker L, Heymann DL, Breman JG: The effect of malaria and malaria prevention in pregnancy and on offspring birthweight, prematurity, and intrauterine growth retardation in rural Malawi. Am J Trop Medicine Hyg. 1996, 55 (1 Suppl): 33-41. Steketee RW, Wirima JJ, Hightower AW, Slutsker L, Heymann DL, Breman JG: The effect of malaria and malaria prevention in pregnancy and on offspring birthweight, prematurity, and intrauterine growth retardation in rural Malawi. Am J Trop Medicine Hyg. 1996, 55 (1 Suppl): 33-41.
4.
go back to reference Steketee RW, Nahlen BL, Parise ME, Menendez C: The burden of malaria in pregnancy in malaria-endemic areas. Am J Trop Med Hyg. 2001, 64 (Suppl 1–2 l): 28-35.PubMed Steketee RW, Nahlen BL, Parise ME, Menendez C: The burden of malaria in pregnancy in malaria-endemic areas. Am J Trop Med Hyg. 2001, 64 (Suppl 1–2 l): 28-35.PubMed
5.
go back to reference Taylor HG, Klein N, Minich NM, Hack M: Middle-school-age outcomes in children with very low birth-weight. Child Develop. 2000, 71: 1495-1511. 10.1111/1467-8624.00242.CrossRefPubMed Taylor HG, Klein N, Minich NM, Hack M: Middle-school-age outcomes in children with very low birth-weight. Child Develop. 2000, 71: 1495-1511. 10.1111/1467-8624.00242.CrossRefPubMed
6.
go back to reference Guyatt HL, Snow RW: Malaria in pregnancy as an indirect cause of infant mortality in sub-Saharan Africa. Trans Royal Soc Trop Med Hyg. 2001, 95: 569-576. 10.1016/S0035-9203(01)90082-3.CrossRef Guyatt HL, Snow RW: Malaria in pregnancy as an indirect cause of infant mortality in sub-Saharan Africa. Trans Royal Soc Trop Med Hyg. 2001, 95: 569-576. 10.1016/S0035-9203(01)90082-3.CrossRef
7.
go back to reference Guyatt HL, Snow RW: Impact of malaria during pregnancy on low birth weight in Sub-Saharan Africa. Clin Microb Rev. 2004, 17: 760-769. 10.1128/CMR.17.4.760-769.2004.CrossRef Guyatt HL, Snow RW: Impact of malaria during pregnancy on low birth weight in Sub-Saharan Africa. Clin Microb Rev. 2004, 17: 760-769. 10.1128/CMR.17.4.760-769.2004.CrossRef
8.
go back to reference Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B: Developmental potential in the first 5 years for children in developing countries. Lancet. 2007, 369: 60-70. 10.1016/S0140-6736(07)60032-4.CrossRefPubMedPubMedCentral Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B: Developmental potential in the first 5 years for children in developing countries. Lancet. 2007, 369: 60-70. 10.1016/S0140-6736(07)60032-4.CrossRefPubMedPubMedCentral
9.
go back to reference WHO: World Malaria Report. 2012, Geneva: World Health Organization, 195. WHO: World Malaria Report. 2012, Geneva: World Health Organization, 195.
10.
go back to reference TDHS: Tanzania Demographic and Health Survey, 2004–2005. 2005, Dar es Salaam, Tanzania, ORC Macro, Calverton, Maryland, USA: National Bureau of Statistics TDHS: Tanzania Demographic and Health Survey, 2004–2005. 2005, Dar es Salaam, Tanzania, ORC Macro, Calverton, Maryland, USA: National Bureau of Statistics
11.
go back to reference TDHS: Tanzania Demographic and Health Survey 2010. 2011, Dar es Salaam, Tanzania, ICF Macro Calverton, Maryland, USA: National Bureau of Statistics TDHS: Tanzania Demographic and Health Survey 2010. 2011, Dar es Salaam, Tanzania, ICF Macro Calverton, Maryland, USA: National Bureau of Statistics
12.
go back to reference THMIS: Tanzania HIV/AIDS and Malaria Indicator Survey 2011–12. 2013, Maryland, USA: TACAIDS, ZAC, NBS, OCGS and ICF International: ICF Macro Calverton THMIS: Tanzania HIV/AIDS and Malaria Indicator Survey 2011–12. 2013, Maryland, USA: TACAIDS, ZAC, NBS, OCGS and ICF International: ICF Macro Calverton
13.
go back to reference MoHSW/IHI/NIMR/WHO: Midterm Analytical Review of the Performance of the Health Sector Strategic Plan III 2009-2015. 2013, Dar es Salaam, Tanzania: Ministry of Health and Social Welfare, Ifakara Health Institute, National Institute for Medical Research and World Health Organization MoHSW/IHI/NIMR/WHO: Midterm Analytical Review of the Performance of the Health Sector Strategic Plan III 2009-2015. 2013, Dar es Salaam, Tanzania: Ministry of Health and Social Welfare, Ifakara Health Institute, National Institute for Medical Research and World Health Organization
14.
go back to reference THMIS: Tanzania HIV/AIDS and Malaria Indicator Survey 2007-08. 2008, Dar es Salaam, Tanzania: National Bureau of Statistics THMIS: Tanzania HIV/AIDS and Malaria Indicator Survey 2007-08. 2008, Dar es Salaam, Tanzania: National Bureau of Statistics
15.
go back to reference Mutagonda R, Kamuhabwa AAR, Massawe S, Mpembeni R: Intermittent Preventive Therapy and Treatment of Malaria during Pregnancy: A Study of Knowledge among Pregnant Women in Rufiji District, Southern Tanzania. Trop J Pharm Res. 2012, 11: 835-845. Mutagonda R, Kamuhabwa AAR, Massawe S, Mpembeni R: Intermittent Preventive Therapy and Treatment of Malaria during Pregnancy: A Study of Knowledge among Pregnant Women in Rufiji District, Southern Tanzania. Trop J Pharm Res. 2012, 11: 835-845.
16.
go back to reference Mubyazi GM, Magnussen P, Goodman C, Bygbjerg IC, Kitua AY, Olsen OE, Byskov J, Hansen KS, Bloch P: Implementing intermittent preventive treatment for malaria in pregnancy: review of prospects, achievements, challenges and agenda for research. Open Trop Med J. 2008, 1: 92-100. 10.2174/1874315300801010092.CrossRefPubMedPubMedCentral Mubyazi GM, Magnussen P, Goodman C, Bygbjerg IC, Kitua AY, Olsen OE, Byskov J, Hansen KS, Bloch P: Implementing intermittent preventive treatment for malaria in pregnancy: review of prospects, achievements, challenges and agenda for research. Open Trop Med J. 2008, 1: 92-100. 10.2174/1874315300801010092.CrossRefPubMedPubMedCentral
17.
go back to reference Uddenfeldt Wort U, Hastings I, Mutabingwa TK, Brabin BJ: The impact of endemic and epidemic malaria on the risk of stillbirth in two areas of Tanzania with different malaria transmission patterns. Malaria J. 2006, 5: 59-10.1186/1475-2875-5-59.CrossRef Uddenfeldt Wort U, Hastings I, Mutabingwa TK, Brabin BJ: The impact of endemic and epidemic malaria on the risk of stillbirth in two areas of Tanzania with different malaria transmission patterns. Malaria J. 2006, 5: 59-10.1186/1475-2875-5-59.CrossRef
18.
go back to reference Lwanga SK, Lemeshow S: Sample Size Determination in Health Studies: A Practical Manual. 1991, Geneva: World Health Organization Lwanga SK, Lemeshow S: Sample Size Determination in Health Studies: A Practical Manual. 1991, Geneva: World Health Organization
20.
go back to reference Mubyazi G, Bloch P, Kamugisha M, Kitua A, Ijumba J: Intermittent preventive treatment of malaria during pregnancy: a qualitative study of knowledge, attitudes and practices of district health managers, antenatal care staff and pregnant women in Korogwe District, North-Eastern Tanzania. Malaria J. 2005, 4: 31-10.1186/1475-2875-4-31.CrossRef Mubyazi G, Bloch P, Kamugisha M, Kitua A, Ijumba J: Intermittent preventive treatment of malaria during pregnancy: a qualitative study of knowledge, attitudes and practices of district health managers, antenatal care staff and pregnant women in Korogwe District, North-Eastern Tanzania. Malaria J. 2005, 4: 31-10.1186/1475-2875-4-31.CrossRef
21.
go back to reference Tarimo DS: Appraisal on the prevalence of malaria and anaemia in pregnancy and factors influencing uptake of intermittent preventive therapy with sulfadoxine-pyrimethamine in Kibaha District, Tanzania. E Afr J Pub Hlth. 2007, 4: 80-83. Tarimo DS: Appraisal on the prevalence of malaria and anaemia in pregnancy and factors influencing uptake of intermittent preventive therapy with sulfadoxine-pyrimethamine in Kibaha District, Tanzania. E Afr J Pub Hlth. 2007, 4: 80-83.
22.
go back to reference Anders K, Marchant T, Chambo P, Mapunda P, Reyburn H: Timing of intermittent preventive treatment for malaria during pregnancy and the implications of current policy on early uptake in north-east Tanzania. Malaria J. 2008, 7: 79-10.1186/1475-2875-7-79.CrossRef Anders K, Marchant T, Chambo P, Mapunda P, Reyburn H: Timing of intermittent preventive treatment for malaria during pregnancy and the implications of current policy on early uptake in north-east Tanzania. Malaria J. 2008, 7: 79-10.1186/1475-2875-7-79.CrossRef
23.
go back to reference Steketee RW, Sipilanyambe N, Chimumbwa J, Banda JJ, Mohamed A, Miller J, Basu S, Miti SK, Campbell CC: National Malaria Control and Scaling Up for Impact: The Zambia Experience through 2006. Am J Trop Med Hyg. 2008, 79: 45-52.PubMed Steketee RW, Sipilanyambe N, Chimumbwa J, Banda JJ, Mohamed A, Miller J, Basu S, Miti SK, Campbell CC: National Malaria Control and Scaling Up for Impact: The Zambia Experience through 2006. Am J Trop Med Hyg. 2008, 79: 45-52.PubMed
24.
go back to reference WHO: Malaria in Pregnancy. Guidelines for Measuring Key Monitoring and Evaluation Indicators. 2007, Geneva: World Health Organization WHO: Malaria in Pregnancy. Guidelines for Measuring Key Monitoring and Evaluation Indicators. 2007, Geneva: World Health Organization
25.
go back to reference Hill J, Hoyt J, van Eijk AM, D’Mello-Guyett L, ter Kuile FO, Steketee R, Smith H, Webster J: Factors affecting the delivery, access, and use of interventions to prevent malaria in pregnancy in Sub-Saharan Africa: A systematic review and meta-analysis. PLoS Med. 2013, 10 (7): e1001488-10.1371/journal.pmed.1001488.CrossRefPubMedPubMedCentral Hill J, Hoyt J, van Eijk AM, D’Mello-Guyett L, ter Kuile FO, Steketee R, Smith H, Webster J: Factors affecting the delivery, access, and use of interventions to prevent malaria in pregnancy in Sub-Saharan Africa: A systematic review and meta-analysis. PLoS Med. 2013, 10 (7): e1001488-10.1371/journal.pmed.1001488.CrossRefPubMedPubMedCentral
26.
go back to reference Marchant T, Nathan R, Jones C, Mponda H, Bruce J, Sedekia Y, Schellenberg J, Mshinda H, Hanson K: Individual, facility, and policy level influences on national coverage estimates for intermittent preventive treatment of malaria in pregnancy in Tanzania. Malaria J. 2008, 7: 260-10.1186/1475-2875-7-260.CrossRef Marchant T, Nathan R, Jones C, Mponda H, Bruce J, Sedekia Y, Schellenberg J, Mshinda H, Hanson K: Individual, facility, and policy level influences on national coverage estimates for intermittent preventive treatment of malaria in pregnancy in Tanzania. Malaria J. 2008, 7: 260-10.1186/1475-2875-7-260.CrossRef
27.
go back to reference Onyeneho NG, Orji BC, Okeinbunor JC, Brieger WR: Characteristics of Nigerian women taking sulfadoxine/pyrimethamine twice during pregnancy for the prevention of malaria. Int J Gyn Obst. 2013, 123: 101-104. 10.1016/j.ijgo.2013.05.019.CrossRef Onyeneho NG, Orji BC, Okeinbunor JC, Brieger WR: Characteristics of Nigerian women taking sulfadoxine/pyrimethamine twice during pregnancy for the prevention of malaria. Int J Gyn Obst. 2013, 123: 101-104. 10.1016/j.ijgo.2013.05.019.CrossRef
28.
go back to reference Mbonye AK, Neema S, Magnussen P: Preventing malaria in pregnancy: a study of perceptions and policy implications in Mukono District, Uganda. Hlth Policy Plan. 2006, 21: 17.CrossRef Mbonye AK, Neema S, Magnussen P: Preventing malaria in pregnancy: a study of perceptions and policy implications in Mukono District, Uganda. Hlth Policy Plan. 2006, 21: 17.CrossRef
29.
go back to reference van Eijk AM, Bles HM, Odhiambo F, Ayisi JG, Blokland IE, Rosen DH, Adazu K, Slutsker L, Lindblade KA: Use of antenatal services and delivery care among women in rural western Kenya: a community based survey. Reprod Hlth. 2006, 3: 2.CrossRef van Eijk AM, Bles HM, Odhiambo F, Ayisi JG, Blokland IE, Rosen DH, Adazu K, Slutsker L, Lindblade KA: Use of antenatal services and delivery care among women in rural western Kenya: a community based survey. Reprod Hlth. 2006, 3: 2.CrossRef
30.
go back to reference Ndyomugyenyi R, Katamanywa J: Intermittent preventive treatment of malaria in pregnancy (IPTp): do frequent antenatal care visits ensure access and compliance to IPTp in Uganda rural communities?. Trans Roy Soc Trop Med Hyg. 2010, 104: 536-540. 10.1016/j.trstmh.2010.02.003.CrossRefPubMed Ndyomugyenyi R, Katamanywa J: Intermittent preventive treatment of malaria in pregnancy (IPTp): do frequent antenatal care visits ensure access and compliance to IPTp in Uganda rural communities?. Trans Roy Soc Trop Med Hyg. 2010, 104: 536-540. 10.1016/j.trstmh.2010.02.003.CrossRefPubMed
31.
go back to reference Hill J, Kazembe R: Reaching the Abuja target for intermittent preventive treatment of malaria in pregnancy in African women: a review of progress and operational challenges. Trop Med Int Health. 2006, 11: 409-418. 10.1111/j.1365-3156.2006.01585.x.CrossRefPubMed Hill J, Kazembe R: Reaching the Abuja target for intermittent preventive treatment of malaria in pregnancy in African women: a review of progress and operational challenges. Trop Med Int Health. 2006, 11: 409-418. 10.1111/j.1365-3156.2006.01585.x.CrossRefPubMed
32.
go back to reference Ouma PO, van Eijk AM, Hamel MJ, Sikuku E, Odhiambo F, Munguti K, Ayisi JG, Kager PA, Slutsker L: The effect of health care worker training on the use of intermittent preventive treatment for malaria in pregnancy in rural western Kenya. Trop Med Int Hlth. 2007, 12: 953-961. 10.1111/j.1365-3156.2007.01876.x.CrossRef Ouma PO, van Eijk AM, Hamel MJ, Sikuku E, Odhiambo F, Munguti K, Ayisi JG, Kager PA, Slutsker L: The effect of health care worker training on the use of intermittent preventive treatment for malaria in pregnancy in rural western Kenya. Trop Med Int Hlth. 2007, 12: 953-961. 10.1111/j.1365-3156.2007.01876.x.CrossRef
33.
go back to reference Manongi RN, Marchant TC, Bygbjerg IC: Improving motivation among primary health care workers in Tanzania: a health worker perspective. Hum Res Hlth. 2006, 4: 6-10.1186/1478-4491-4-6.CrossRef Manongi RN, Marchant TC, Bygbjerg IC: Improving motivation among primary health care workers in Tanzania: a health worker perspective. Hum Res Hlth. 2006, 4: 6-10.1186/1478-4491-4-6.CrossRef
34.
go back to reference Ahmed AM, Desta A, Tekle K, Mweta EA: Pursuing better health care delivery at district level. World Health Forum. 1993, 14: 360-366.PubMed Ahmed AM, Desta A, Tekle K, Mweta EA: Pursuing better health care delivery at district level. World Health Forum. 1993, 14: 360-366.PubMed
35.
go back to reference Ben Salem B, Beattie KJ: Facilitate supervision: a vital link in quality of reproductive health service delivery. Engender Health Working Paper No. 10. 1996, New York: AVSC International Ben Salem B, Beattie KJ: Facilitate supervision: a vital link in quality of reproductive health service delivery. Engender Health Working Paper No. 10. 1996, New York: AVSC International
Metadata
Title
Accessibility, availability and utilisation of malaria interventions among women of reproductive age in Kilosa district in central Tanzania
Authors
Susan F Rumisha
Maria M Zinga
Carolyn A Fahey
Dorothy Wei
Veneranda M Bwana
Malongo RS Mlozi
Elizabeth H Shayo
Robert C Malima
Benjamin K Mayala
Grades Stanley
Tabitha Mlacha
Leonard EG Mboera
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-452

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