Factors influencing utilization of intermittent preventive treatment of malaria during pregnancy among mothers of under-one children in rural Lilongwe, Malawi


  • Taonga Mafuleka (1) Ministry of Health, P.O. Box 30377, Lilongwe 3, Malawi; (2) College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
  • Montakarn Cheumchit College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand


Antenatal care, Intermittent Preventive Treatment, Malaria, Pregnancy, Sulphadoxine Pyrimethamine, Malawi


Purpose - Routine administration of Sulphadoxine Pyrimethamine (SP) for intermittent preventive treatment (IPTp) of malaria during pregnancy leads to improvement of maternal health and pregnancy outcomes. This study explored determinants for IPTp-SP utilization among pregnant women in rural Lilongwe, Malawi.

Design/methodology/approach - A multi-stage sampling method was used to recruit 355 mothers of under-one children. Face-to-face interview was conducted. Bivariate and multivariate statistical models were executed in analyzing data. 

Findings - Overall, 84.0% of the mothers attended at least 3 antenatal care (ANC) visits, effectively positioning themselves to the likelihood of receiving optimal IPTp-SP (3+ doses). Only 24.8% of the mothers received the recommended doses; 52.7% and 22.5% took partial and nil doses. Factors associated with IPTp-SP utilization included knowledge, attitudes, timing of ANC visit, frequency of ANC visits, health education, and perceived benefits of IPTp-SP. Client satisfaction with ANC services (AOR 1.94; 95% CI 1.07-3.51), and receipt of SP under health worker’ observation (AOR 6.96; 95% CI 2.04-23.71) increased the likelihood of optimal utilization.

Originality/value - Despite high ANC attendance rate, optimal IPTp-SP utilization area is low. Apart from the identified client-level factors, this low coverage can be attributed to health workers’ non-adherence to IPTp-SP guidelines leading to missing opportunities. Program efforts should aim at addressing the identified knowledge gaps and reinforcing community trust in the intervention. Operational research is recommended to explore bottlenecks limiting effective coverage of the intervention.


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How to Cite

Mafuleka, T., & Cheumchit, M. (2018). Factors influencing utilization of intermittent preventive treatment of malaria during pregnancy among mothers of under-one children in rural Lilongwe, Malawi. Journal of Health Research, 32(Suppl.1), S62-S75. Retrieved from https://he01.tci-thaijo.org/index.php/jhealthres/article/view/164653