Intermittent preventive treatment of malaria in pregnancy (IPTp): do frequent antenatal care visits ensure access and compliance to IPTp in Ugandan rural communities?

Trans R Soc Trop Med Hyg. 2010 Aug;104(8):536-40. doi: 10.1016/j.trstmh.2010.02.003. Epub 2010 Mar 15.


The relationship between antenatal care (ANC) visits and coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP), and barriers to IPTp-SP access were examined. Four hundred and fifty-three women who had given birth during the study period were interviewed using a semi-structured questionnaire. Of these, 425 (93.8%) attended ANC at least once, but only 90 (21.2%) made four or more visits. Primigravidae 25 (29.8%) were more likely than multigravidae 65 (17.6%) to make more than four visits (P=0.012). Only 237 (52.3%) women accessed two or more doses of IPT-SP, which increased with the number of ANC visits (X(2) for linear trends, 117.7, P<0.001). However, 131 (28.9%) women made two or more ANC visits, which were sufficient for them to access two or more doses of IPTp-SP, but they did not. The main reasons were: not given SP by the midwife for unknown reasons 36 (27.5%), SP stock-outs 34 (26%) and irregular ANC attendance 18 (13.7%). Frequent ANC visits do not seem to ensure access to IPTp-SP in the presence of other barriers. The Roll Back Malaria target of 80% of women accessing two or more doses of IPTp-SP by 2010 appears unachievable unless alternative channels of delivery are found.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antimalarials / therapeutic use*
  • Child
  • Drug Combinations
  • Female
  • Health Services Accessibility / standards
  • Humans
  • Malaria / drug therapy
  • Malaria / epidemiology
  • Malaria / prevention & control*
  • Medication Adherence / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy
  • Pregnancy Complications, Infectious / epidemiology
  • Pregnancy Complications, Infectious / prevention & control*
  • Prenatal Care / standards
  • Prenatal Care / statistics & numerical data*
  • Pyrimethamine / therapeutic use*
  • Sulfadoxine / therapeutic use*
  • Surveys and Questionnaires
  • Uganda / epidemiology
  • Young Adult


  • Antimalarials
  • Drug Combinations
  • fanasil, pyrimethamine drug combination
  • Sulfadoxine
  • Pyrimethamine