Contributors to disparity in missed opportunity for intermittent preventive treatment for malaria in pregnancy in Nigeria

Abstract

Background: Malaria remains a challenging public health issue in Africa, with preponderance for pregnant women. Considering Nigeria's significant contribution to the global burden of malaria, the low uptake of IPTp-S P is of significant concern considering several evidences of disparity in missed opportunity for delivering IPTp-SP. This study was conducted to determine the contributors to and the magnitude of their effect on uptake, to provide baseline information for measuring disparity and monitoring effects of interventions through trend analysis. Method: The Nigeria Demographic Health Survey (NDHS) dataset 2013 was used and data on socio-demographic, (Antenatal care) ANC characteristics and IPTp-SP use were used to assess IPTp uptake and missed opportunity. A missed opportunity for IPTp delivery is an ANC visit in which IPTp was not delivered per policy. Analysis was done using SPSS version 21. Measures of associations used chi-square test. The level of significance was set at 5%. Index of disparity was used as a summary measure of disparity for determinants of missed opportunity. Results: The mean age of the respondents was 28.69±0.19 years. Majority (25.4%) were Hausa/ Fulani tribe, 41.5% had secondary education. Most (28.6%) are of the richest wealth quintile, 52.6% are Christians and 94.9% are currently cohabiting. Majority (51.1%) resided in urban area and (23.5%) South West while 41.1% had less than two previous pregnancies. Contributors to disparity for missed opportunity in Nigeria were level of education, wealth index, ethnicity, place of residence, region and parity of respondents. The greatest contributor to disparity for missed opportunity was region of residence with the least being parity. Conclusion: The need for strategic cost-effective interventions that focuses on the greatest contributors to decrease disparity for missed opportunity is important. There is an increased need to explore regional determinants of missed opportunity.