ArticleMalaria journal2022
A qualitative assessment of the health systems factors influencing the prevention of malaria in pregnancy using intermittent preventive treatment and insecticide-treated nets in Ghana.
Article in Malaria journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 17 citations in OpenAlex.
- Factors influencing the utilisation of malaria preventive services during pregnancy in Ile Ife, Nigeria: a mixed method approach.Malaria journal · 2026Article
- Wealth-based inequalities in the uptake of three or more doses of intermittent preventive treatment in pregnancy in West Africa, 2015-2021.Malaria journal · 2025Article
- Association between adequacy of antenatal care and uptake of intermittent preventive treatment of malaria in pregnancy among women in Ghana.Malaria journal · 2025Article
- Malaria in pregnancy: a holistic exploration of synergistic association through environmental, sociocultural, and socioeconomic lenses in Pru east municipality, Ghana.Malaria journal · 2025Article
- Enhancing the uptake of intermittent preventive treatment for malaria in pregnancy: a scoping review of interventions and gender-informed approaches.Malaria journal · 2025Article
- Article
- Spatial distribution and determinants of intermittent preventive treatment for malaria during pregnancy: a secondary data analysis of the 2019 Ghana malaria indicators survey.BMC pregnancy and childbirth · 2024Article
- Synthesis of Qualitative Evidence on Malaria in Pregnancy, 2005-2022: A Systematic Review.Tropical medicine and infectious disease · 2023Review
- Interventions for malaria prevention in pregnancy; factors influencing uptake and their effect on pregnancy outcomes among post-natal women in a tertiary facility in the Volta Region of Ghana.SAGE open medicine · 2023Article
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundGhana has adopted and implemented intermittent preventive treatment using sulfadoxine-pyrimethamine (IPTp-SP) and insecticide-treated nets (ITNs) in an antenatal care (ANC) context to prevent malaria among pregnant women. However, the increased ANC attendance and its frequency facilitated by a free maternal health care policy in Ghana does not correspond with the uptake of IPTp-SP and ITN use among pregnant women. This study sought to elucidate the contextual health system factors influencing the delivery of IPTp-SP and ITN from a related quantitative study conducted in Ghana.
methodsThis is the qualitative section of a mixed-methods study design, where audio recorded key informant interviews (KIIs) were conducted with health workers from across health facilities, districts, regional and national health directorates. The KIIs elicited information on health worker knowledge, perceptions, and rationale for the delivery practices of IPTp-SP and ITN revealed in the quantitative findings. The interviews were transcribed and imported into NVivo for analysis. Using the World Health Organization (WHO) Health Systems Framework as the theoretical basis, thematic analysis was conducted under broad themes of the building blocks. Findings are presented in narrative quotes, with a mindmap used to summarize the various health system factors and their interrelated relationship influencing the delivery of IPTp-SP and ITN.
resultsHealth system factors identified included health staff untrained on malaria delivery directives due to an ineffective trainer of trainer (ToT) system. Additionally, health worker confusion on when to commence SP (at quickening or ≥ 16 weeks) was found to result in delayed start of SP. Stock-outs in facilities due to procurement delays at the national level resulted in missed opportunities to deliver SP to eligible pregnant women at the ANC. Similarly, ITN stock outs led to eligible pregnant women not receiving one at ANC clinics.
conclusionPoor health worker knowledge on policy directives, a consequence of ineffective training strategy led to delayed delivery of IPTp-SP to eligible pregnant women. Supply chain management challenges related to stock of SP and ITN resulted in missed opportunities to deliver the interventions to pregnant women attending ANC.
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