An ethnographic study of how health system, socio-cultural and individual factors influence uptake of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine in a Ghanaian context
Intermittent preventive treatment of malaria among pregnant women with sulfadoxine-pyrimethamine (IPTp-SP), is one of the three recommended interventions for the prevention of malaria in pregnancy (MiP) in sub-Sahara Africa. The World Health Organisation recommended in 2012 that SP be given at each...
Gespeichert in:
| Veröffentlicht in: | PloS one 2021-10, Vol.16 (10), p.e0257666-e0257666 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0257666 |
|---|---|
| container_issue | 10 |
| container_start_page | e0257666 |
| container_title | PloS one |
| container_volume | 16 |
| creator | Aberese-Ako, Matilda Magnussen, Pascal Ampofo, Gifty D Gyapong, Margaret Ansah, Evelyn Tagbor, Harry |
| description | Intermittent preventive treatment of malaria among pregnant women with sulfadoxine-pyrimethamine (IPTp-SP), is one of the three recommended interventions for the prevention of malaria in pregnancy (MiP) in sub-Sahara Africa. The World Health Organisation recommended in 2012 that SP be given at each scheduled ANC visit except during the first trimester and can be given a dose every month until the time of delivery, to ensure that a high proportion of women receive at least three doses of SP during pregnancy. Despite implementation of this policy, Ghana did not attain the target of 100% access to IPTp-SP by 2015. Additionally, negative outcomes of malaria infection in pregnancy are still recurring. This ethnographic study explored how health system, individual and socio-cultural factors influence IPTp-SP uptake in two Ghanaian regions. The study design was ethnographic, employing non-participant observation, case studies and in depth interviews in 8 health facilities and 8 communities, from April 2018 to March 2019, in two Ghanaian regions. Recommended ethical procedures were observed. Health system factors such as organization of antenatal care (ANC) services and strategies employed by health workers to administer SP contributed to initial uptake. Women's trust in the health care system contributed to continued uptake. Inadequate information provided to women accessing ANC, stock-outs and fees charged for ANC services reduced access to IPTp-SP. Socio-cultural factor such as encouragement from social networks influenced utilization of ANC services and IPTp-SP uptake. Individual factors such as refusing to take SP, skipping ANC appointments and initiating ANC attendance late affected uptake. Health system, socio-cultural and individual factors influence uptake of optimum doses of IPTp-SP. Consequently, interventions that aim at addressing IPTp-SP uptake should focus on regular and sufficient supply of SP to health facilities, effective implementation of free ANC, provision of appropriate and adequate information to women and community outreach programmes to encourage early and regular ANC visits. |
| doi_str_mv | 10.1371/journal.pone.0257666 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2580000660</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A678258811</galeid><doaj_id>oai_doaj_org_article_b6f2b9ceaadd40cb85bdcf9e7ba0d0ae</doaj_id><sourcerecordid>A678258811</sourcerecordid><originalsourceid>FETCH-LOGICAL-c669t-d1179799d2288f016486c7d20e73417e0e2d03060902aae59c1fe5deeec7c813</originalsourceid><addsrcrecordid>eNqNk9-L1DAQx4sonp7-B4IBQRTcNWm7afsiHIeeBwcHevgaZpPpNmeb1PzYu_0__YNM3Sq3cg-mD2kmn3xnMpPJsheMLllRsffXNjoD_XK0Bpc0X1Wc8wfZE9YU-YLntHh45_8oe-r9NaWroub8cXZUlJzVNcufZD9PDMHQGbtxMHZaEh-i2hHbks7ekA6hDx3xOx9weEe8ldouZOxDdNATMIpoo_RWq5iWLchgnU-mto9oJJI4BviOk5g2Ad2gQ0ATyOhwm2a9RRIcQhgmY4IG6MFpSPCEbAwYuSM3egog9i0oe6sNLsad00MKGYa0mlggZx0Y0GCItMnPbXiWPWqh9_h8no-zq08fr04_Ly4uz85PTy4WkvMmLBRjVVM1jcrzum4p42XNZaVyilVRsgop5ooWlNOG5gC4aiRrcaUQUVayZsVx9nIvO_bWi7keXuSrmqbBOU3E-Z5QFq7FmAIHtxMWtPhtsG4jwAUtexRr3ubrRiKAUiWV63q1VrJtsFoDVRQwaX2YvcX1gEqmpKUiHIge7hjdiY3dirpseM2LJPBmFnD2R0QfxKC9xL4Hgzbu4-ZNwcoyoa_-Qe-_3UxtIF0gld0mv3ISFSe8qhNZsylLy3uo9CkcdCoYtjrZDw68PTgwF3UD0Xtx_vXL_7OX3w7Z13fY_dP2to9BW-MPwXIPSme9d9j-TTKjYuq9P9kQU--JufeKX7QyJ0g</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2580000660</pqid></control><display><type>article</type><title>An ethnographic study of how health system, socio-cultural and individual factors influence uptake of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine in a Ghanaian context</title><source>DOAJ Directory of Open Access Journals</source><source>Public Library of Science (PLoS) Journals Open Access</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Aberese-Ako, Matilda ; Magnussen, Pascal ; Ampofo, Gifty D ; Gyapong, Margaret ; Ansah, Evelyn ; Tagbor, Harry</creator><contributor>Chico, R Matthew</contributor><creatorcontrib>Aberese-Ako, Matilda ; Magnussen, Pascal ; Ampofo, Gifty D ; Gyapong, Margaret ; Ansah, Evelyn ; Tagbor, Harry ; Chico, R Matthew</creatorcontrib><description>Intermittent preventive treatment of malaria among pregnant women with sulfadoxine-pyrimethamine (IPTp-SP), is one of the three recommended interventions for the prevention of malaria in pregnancy (MiP) in sub-Sahara Africa. The World Health Organisation recommended in 2012 that SP be given at each scheduled ANC visit except during the first trimester and can be given a dose every month until the time of delivery, to ensure that a high proportion of women receive at least three doses of SP during pregnancy. Despite implementation of this policy, Ghana did not attain the target of 100% access to IPTp-SP by 2015. Additionally, negative outcomes of malaria infection in pregnancy are still recurring. This ethnographic study explored how health system, individual and socio-cultural factors influence IPTp-SP uptake in two Ghanaian regions. The study design was ethnographic, employing non-participant observation, case studies and in depth interviews in 8 health facilities and 8 communities, from April 2018 to March 2019, in two Ghanaian regions. Recommended ethical procedures were observed. Health system factors such as organization of antenatal care (ANC) services and strategies employed by health workers to administer SP contributed to initial uptake. Women's trust in the health care system contributed to continued uptake. Inadequate information provided to women accessing ANC, stock-outs and fees charged for ANC services reduced access to IPTp-SP. Socio-cultural factor such as encouragement from social networks influenced utilization of ANC services and IPTp-SP uptake. Individual factors such as refusing to take SP, skipping ANC appointments and initiating ANC attendance late affected uptake. Health system, socio-cultural and individual factors influence uptake of optimum doses of IPTp-SP. Consequently, interventions that aim at addressing IPTp-SP uptake should focus on regular and sufficient supply of SP to health facilities, effective implementation of free ANC, provision of appropriate and adequate information to women and community outreach programmes to encourage early and regular ANC visits.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0257666</identifier><identifier>PMID: 34618812</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Antimalarial agents ; Biology and Life Sciences ; Complications and side effects ; Drug dosages ; Economic aspects ; Ethics ; Ethnography ; Health aspects ; Health care ; Health care facilities ; Health care policy ; Health facilities ; Intervention ; Malaria ; Medical personnel ; Medical research ; Medicine and Health Sciences ; Medicine, Preventive ; Patient outcomes ; People and Places ; Pregnancy ; Pregnant women ; Prenatal care ; Prevention ; Preventive health services ; Pyrimethamine ; Social aspects ; Social networks ; Social organization ; Sulfadoxine ; Vector-borne diseases ; Womens health</subject><ispartof>PloS one, 2021-10, Vol.16 (10), p.e0257666-e0257666</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Aberese-Ako et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Aberese-Ako et al 2021 Aberese-Ako et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c669t-d1179799d2288f016486c7d20e73417e0e2d03060902aae59c1fe5deeec7c813</citedby><cites>FETCH-LOGICAL-c669t-d1179799d2288f016486c7d20e73417e0e2d03060902aae59c1fe5deeec7c813</cites><orcidid>0000-0002-1577-5939</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496863/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496863/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids></links><search><contributor>Chico, R Matthew</contributor><creatorcontrib>Aberese-Ako, Matilda</creatorcontrib><creatorcontrib>Magnussen, Pascal</creatorcontrib><creatorcontrib>Ampofo, Gifty D</creatorcontrib><creatorcontrib>Gyapong, Margaret</creatorcontrib><creatorcontrib>Ansah, Evelyn</creatorcontrib><creatorcontrib>Tagbor, Harry</creatorcontrib><title>An ethnographic study of how health system, socio-cultural and individual factors influence uptake of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine in a Ghanaian context</title><title>PloS one</title><description>Intermittent preventive treatment of malaria among pregnant women with sulfadoxine-pyrimethamine (IPTp-SP), is one of the three recommended interventions for the prevention of malaria in pregnancy (MiP) in sub-Sahara Africa. The World Health Organisation recommended in 2012 that SP be given at each scheduled ANC visit except during the first trimester and can be given a dose every month until the time of delivery, to ensure that a high proportion of women receive at least three doses of SP during pregnancy. Despite implementation of this policy, Ghana did not attain the target of 100% access to IPTp-SP by 2015. Additionally, negative outcomes of malaria infection in pregnancy are still recurring. This ethnographic study explored how health system, individual and socio-cultural factors influence IPTp-SP uptake in two Ghanaian regions. The study design was ethnographic, employing non-participant observation, case studies and in depth interviews in 8 health facilities and 8 communities, from April 2018 to March 2019, in two Ghanaian regions. Recommended ethical procedures were observed. Health system factors such as organization of antenatal care (ANC) services and strategies employed by health workers to administer SP contributed to initial uptake. Women's trust in the health care system contributed to continued uptake. Inadequate information provided to women accessing ANC, stock-outs and fees charged for ANC services reduced access to IPTp-SP. Socio-cultural factor such as encouragement from social networks influenced utilization of ANC services and IPTp-SP uptake. Individual factors such as refusing to take SP, skipping ANC appointments and initiating ANC attendance late affected uptake. Health system, socio-cultural and individual factors influence uptake of optimum doses of IPTp-SP. Consequently, interventions that aim at addressing IPTp-SP uptake should focus on regular and sufficient supply of SP to health facilities, effective implementation of free ANC, provision of appropriate and adequate information to women and community outreach programmes to encourage early and regular ANC visits.</description><subject>Antimalarial agents</subject><subject>Biology and Life Sciences</subject><subject>Complications and side effects</subject><subject>Drug dosages</subject><subject>Economic aspects</subject><subject>Ethics</subject><subject>Ethnography</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health care facilities</subject><subject>Health care policy</subject><subject>Health facilities</subject><subject>Intervention</subject><subject>Malaria</subject><subject>Medical personnel</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Medicine, Preventive</subject><subject>Patient outcomes</subject><subject>People and Places</subject><subject>Pregnancy</subject><subject>Pregnant women</subject><subject>Prenatal care</subject><subject>Prevention</subject><subject>Preventive health services</subject><subject>Pyrimethamine</subject><subject>Social aspects</subject><subject>Social networks</subject><subject>Social organization</subject><subject>Sulfadoxine</subject><subject>Vector-borne diseases</subject><subject>Womens health</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk9-L1DAQx4sonp7-B4IBQRTcNWm7afsiHIeeBwcHevgaZpPpNmeb1PzYu_0__YNM3Sq3cg-mD2kmn3xnMpPJsheMLllRsffXNjoD_XK0Bpc0X1Wc8wfZE9YU-YLntHh45_8oe-r9NaWroub8cXZUlJzVNcufZD9PDMHQGbtxMHZaEh-i2hHbks7ekA6hDx3xOx9weEe8ldouZOxDdNATMIpoo_RWq5iWLchgnU-mto9oJJI4BviOk5g2Ad2gQ0ATyOhwm2a9RRIcQhgmY4IG6MFpSPCEbAwYuSM3egog9i0oe6sNLsad00MKGYa0mlggZx0Y0GCItMnPbXiWPWqh9_h8no-zq08fr04_Ly4uz85PTy4WkvMmLBRjVVM1jcrzum4p42XNZaVyilVRsgop5ooWlNOG5gC4aiRrcaUQUVayZsVx9nIvO_bWi7keXuSrmqbBOU3E-Z5QFq7FmAIHtxMWtPhtsG4jwAUtexRr3ubrRiKAUiWV63q1VrJtsFoDVRQwaX2YvcX1gEqmpKUiHIge7hjdiY3dirpseM2LJPBmFnD2R0QfxKC9xL4Hgzbu4-ZNwcoyoa_-Qe-_3UxtIF0gld0mv3ISFSe8qhNZsylLy3uo9CkcdCoYtjrZDw68PTgwF3UD0Xtx_vXL_7OX3w7Z13fY_dP2to9BW-MPwXIPSme9d9j-TTKjYuq9P9kQU--JufeKX7QyJ0g</recordid><startdate>20211007</startdate><enddate>20211007</enddate><creator>Aberese-Ako, Matilda</creator><creator>Magnussen, Pascal</creator><creator>Ampofo, Gifty D</creator><creator>Gyapong, Margaret</creator><creator>Ansah, Evelyn</creator><creator>Tagbor, Harry</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-1577-5939</orcidid></search><sort><creationdate>20211007</creationdate><title>An ethnographic study of how health system, socio-cultural and individual factors influence uptake of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine in a Ghanaian context</title><author>Aberese-Ako, Matilda ; Magnussen, Pascal ; Ampofo, Gifty D ; Gyapong, Margaret ; Ansah, Evelyn ; Tagbor, Harry</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-d1179799d2288f016486c7d20e73417e0e2d03060902aae59c1fe5deeec7c813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antimalarial agents</topic><topic>Biology and Life Sciences</topic><topic>Complications and side effects</topic><topic>Drug dosages</topic><topic>Economic aspects</topic><topic>Ethics</topic><topic>Ethnography</topic><topic>Health aspects</topic><topic>Health care</topic><topic>Health care facilities</topic><topic>Health care policy</topic><topic>Health facilities</topic><topic>Intervention</topic><topic>Malaria</topic><topic>Medical personnel</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Medicine, Preventive</topic><topic>Patient outcomes</topic><topic>People and Places</topic><topic>Pregnancy</topic><topic>Pregnant women</topic><topic>Prenatal care</topic><topic>Prevention</topic><topic>Preventive health services</topic><topic>Pyrimethamine</topic><topic>Social aspects</topic><topic>Social networks</topic><topic>Social organization</topic><topic>Sulfadoxine</topic><topic>Vector-borne diseases</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aberese-Ako, Matilda</creatorcontrib><creatorcontrib>Magnussen, Pascal</creatorcontrib><creatorcontrib>Ampofo, Gifty D</creatorcontrib><creatorcontrib>Gyapong, Margaret</creatorcontrib><creatorcontrib>Ansah, Evelyn</creatorcontrib><creatorcontrib>Tagbor, Harry</creatorcontrib><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aberese-Ako, Matilda</au><au>Magnussen, Pascal</au><au>Ampofo, Gifty D</au><au>Gyapong, Margaret</au><au>Ansah, Evelyn</au><au>Tagbor, Harry</au><au>Chico, R Matthew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An ethnographic study of how health system, socio-cultural and individual factors influence uptake of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine in a Ghanaian context</atitle><jtitle>PloS one</jtitle><date>2021-10-07</date><risdate>2021</risdate><volume>16</volume><issue>10</issue><spage>e0257666</spage><epage>e0257666</epage><pages>e0257666-e0257666</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Intermittent preventive treatment of malaria among pregnant women with sulfadoxine-pyrimethamine (IPTp-SP), is one of the three recommended interventions for the prevention of malaria in pregnancy (MiP) in sub-Sahara Africa. The World Health Organisation recommended in 2012 that SP be given at each scheduled ANC visit except during the first trimester and can be given a dose every month until the time of delivery, to ensure that a high proportion of women receive at least three doses of SP during pregnancy. Despite implementation of this policy, Ghana did not attain the target of 100% access to IPTp-SP by 2015. Additionally, negative outcomes of malaria infection in pregnancy are still recurring. This ethnographic study explored how health system, individual and socio-cultural factors influence IPTp-SP uptake in two Ghanaian regions. The study design was ethnographic, employing non-participant observation, case studies and in depth interviews in 8 health facilities and 8 communities, from April 2018 to March 2019, in two Ghanaian regions. Recommended ethical procedures were observed. Health system factors such as organization of antenatal care (ANC) services and strategies employed by health workers to administer SP contributed to initial uptake. Women's trust in the health care system contributed to continued uptake. Inadequate information provided to women accessing ANC, stock-outs and fees charged for ANC services reduced access to IPTp-SP. Socio-cultural factor such as encouragement from social networks influenced utilization of ANC services and IPTp-SP uptake. Individual factors such as refusing to take SP, skipping ANC appointments and initiating ANC attendance late affected uptake. Health system, socio-cultural and individual factors influence uptake of optimum doses of IPTp-SP. Consequently, interventions that aim at addressing IPTp-SP uptake should focus on regular and sufficient supply of SP to health facilities, effective implementation of free ANC, provision of appropriate and adequate information to women and community outreach programmes to encourage early and regular ANC visits.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34618812</pmid><doi>10.1371/journal.pone.0257666</doi><tpages>e0257666</tpages><orcidid>https://orcid.org/0000-0002-1577-5939</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-10, Vol.16 (10), p.e0257666-e0257666 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2580000660 |
| source | DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Antimalarial agents Biology and Life Sciences Complications and side effects Drug dosages Economic aspects Ethics Ethnography Health aspects Health care Health care facilities Health care policy Health facilities Intervention Malaria Medical personnel Medical research Medicine and Health Sciences Medicine, Preventive Patient outcomes People and Places Pregnancy Pregnant women Prenatal care Prevention Preventive health services Pyrimethamine Social aspects Social networks Social organization Sulfadoxine Vector-borne diseases Womens health |
| title | An ethnographic study of how health system, socio-cultural and individual factors influence uptake of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine in a Ghanaian context |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T10%3A11%3A18IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=An%20ethnographic%20study%20of%20how%20health%20system,%20socio-cultural%20and%20individual%20factors%20influence%20uptake%20of%20intermittent%20preventive%20treatment%20of%20malaria%20in%20pregnancy%20with%20sulfadoxine-pyrimethamine%20in%20a%20Ghanaian%20context&rft.jtitle=PloS%20one&rft.au=Aberese-Ako,%20Matilda&rft.date=2021-10-07&rft.volume=16&rft.issue=10&rft.spage=e0257666&rft.epage=e0257666&rft.pages=e0257666-e0257666&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0257666&rft_dat=%3Cgale_plos_%3EA678258811%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2580000660&rft_id=info:pmid/34618812&rft_galeid=A678258811&rft_doaj_id=oai_doaj_org_article_b6f2b9ceaadd40cb85bdcf9e7ba0d0ae&rfr_iscdi=true |