Анотація
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-SP 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 sociodemographic, (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.
Keywords: Disparity, missed opportunity, intermittent preventive treatment of malaria, malaria in pregnancy, Nigeria.
Abstrait
Contexte : Le paludisme reste un problème de santé publique difficile en Afrique, avec une prépondérance pour les femmes enceintes. Compte tenu de l’importante contribution du Nigeria à la
charge mondiale du paludisme, la faible absorption d’IPTp -SP est très préoccupante compte tenu de plusieurs preuves de disparité dans occasion manquée pour la prestation IPTp -SP. Cette étude a été menée dans le but de déterminer les facteurs contributifs et l’ampleur de leur effet sur l’absorption, afin de fournir des informations de base permettant de mesurer les disparités et de surveiller les effets des interventions au moyen d’une analyse des tendances.
Méthode : L’ensemble de données de l’enquête sur la santé démographique du Nigeria (NDHS) 2013 a été utilisé et les données sur les caractéristiques socio-démographiques de l’ANC, (soins prénatals) et l’utilisation d’IPTp -SP ont été utilisés pour évaluer l’absorption d’IPTp et opportunité manquée. Une opportunité manquée pour la prestation IPTp est une visite ANC au cours de laquelle IPTp n’a pas été livré conformément à la stratégie. L’analyse a été réalisée à l’aide de la version 21 de SPSS. Les mesures d’associations ont été utilisées avec le test du chi-carré. Le niveau de signification a été fixé à 5%. L’indice de disparité a été utilisé comme mesure synthétique de la disparité pour les déterminants des opportunités manquées.
Résultats: L’âge moyen des répondants est de 28,69 ± 0,19 ans. La majorité (25,4%) était composée de tribus Hausa / Fulani, 41,5% avaient suivi des études secondaires. La plupart (28,6%) appartiennent au quintile de richesse le plus riche, 52,6% sont chrétiens et 94,9% cohabitent actuellement. La majorité (51,1%) réside en zone urbaine et (23,5%) dans le sud-ouest, tandis que 41,1% ont eu moins de deux grossesses antérieures. Les facteurs contribuant à la disparité des opportunités manquées au Nigéria sont le niveau d’éducation, l’indice de richesse, l’origine ethnique, le lieu de résidence, la région et la parité des répondants. Le facteur qui contribue le plus à la disparité des opportunités manquées est la région de résidence, le moins égal étant la parité.
Conclusion: Le besoin d’interventions stratégiques rentables axées sur les principaux contributeurs afin de réduire les disparités pour les opportunités manquées est important. Il est de plus en plus nécessaire d’explorer les déterminants régionaux des opportunités manquées.
Mots - clés: Disparité, opportunité manquée, traitement préventif intermittent du paludisme, paludisme pendant la grossesse, Nigéria.
Correspondence: Dr. O.O. Olukoya, Department of Community Medicine, University College Hospital, Ibadan, Nigeria. E-mail:ebemiol@gmail.com
Посилання
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