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Introduction <p>Malaria in pregnancy is a significant public health concern in sub-Saharan Africa, affecting an estimated 32&#xa0;million pregnant women annually. One of WHO’s recommendations for malaria prevention is the use of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). However, reports indicate that less than 100% of women in Ghana access IPTp service. This study explored knowledge, attitudes, uptake, and future intentions to take IPTp-SP among pregnant women in southern Ghana.</p> Methodology <p>An ethnographic study design was used. Data was collected from April 20,218 to March 2019 using in-depth interviews, conversations, and non-participant observations, among pregnant women, health workers, managers, and a cross-section of community members. The interviews were recorded digitally, transcribed, and uploaded together with the transcribed conversations and observation notes into NVivo Version 11 for triangulation, coding, and thematic analysis. All ethical procedures were followed.</p> Results <p>Six major themes were identified: The context of SP administration as observed at the ANC, Post-SP advice and counseling by health providers, Knowledge of the benefits of intermittent preventive therapy in pregnancy, Frequency of SP uptake and Knowledge of recommended dosing, experience in taking in SP, and intentions of future uptake of SP. The findings show that SP uptake was well integrated into routine antenatal care and delivered through a structured, provider-led process under direct observation. Mandatory water intake and advice to eat heavy meals were common practices. Counselling on SP varied across clients and was generally limited after administration, particularly regarding side effects. Most participants received three or more SP doses in line with national guidelines and demonstrated strong trust in healthcare providers. However, knowledge of correct dosage and timing was limited, with misconceptions evident. Despite experiencing discomfort such as nausea and dizziness, most women continued SP use due to perceived maternal and fetal benefits.</p> Conclusion <p>Strengthening communication between healthcare providers and pregnant women regarding dosing schedules, potential side effects, and follow-up doses could improve adherence and optimize the effectiveness of malaria prevention strategies.</p>

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Knowledge, attitudes, practices, and future intentions to use intermittent preventive treatment with sulfadoxine-pyrimethamine among pregnant women in southern Ghana

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  • 发表日期：

    2026年4月15日

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  • Matilda Aberese-Ako,
  • Wisdom Ebelin,
  • Pascal Magnussen,
  • Kingsford Norshie,
  • Desmond Klu,
  • Mustapha Immurana,
  • Gifty D. Ampofo,
  • Harry Tagbor

摘要

Introduction

Malaria in pregnancy is a significant public health concern in sub-Saharan Africa, affecting an estimated 32 million pregnant women annually. One of WHO’s recommendations for malaria prevention is the use of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). However, reports indicate that less than 100% of women in Ghana access IPTp service. This study explored knowledge, attitudes, uptake, and future intentions to take IPTp-SP among pregnant women in southern Ghana.

Methodology

An ethnographic study design was used. Data was collected from April 20,218 to March 2019 using in-depth interviews, conversations, and non-participant observations, among pregnant women, health workers, managers, and a cross-section of community members. The interviews were recorded digitally, transcribed, and uploaded together with the transcribed conversations and observation notes into NVivo Version 11 for triangulation, coding, and thematic analysis. All ethical procedures were followed.

Results

Six major themes were identified: The context of SP administration as observed at the ANC, Post-SP advice and counseling by health providers, Knowledge of the benefits of intermittent preventive therapy in pregnancy, Frequency of SP uptake and Knowledge of recommended dosing, experience in taking in SP, and intentions of future uptake of SP. The findings show that SP uptake was well integrated into routine antenatal care and delivered through a structured, provider-led process under direct observation. Mandatory water intake and advice to eat heavy meals were common practices. Counselling on SP varied across clients and was generally limited after administration, particularly regarding side effects. Most participants received three or more SP doses in line with national guidelines and demonstrated strong trust in healthcare providers. However, knowledge of correct dosage and timing was limited, with misconceptions evident. Despite experiencing discomfort such as nausea and dizziness, most women continued SP use due to perceived maternal and fetal benefits.

Conclusion

Strengthening communication between healthcare providers and pregnant women regarding dosing schedules, potential side effects, and follow-up doses could improve adherence and optimize the effectiveness of malaria prevention strategies.