Introduction: Malaria poses considerable risk to pregnant women and their unborn babies. Despite the known effectiveness of intermittent preventive treatment in pregnancy using sulfadoxine pyrimethamine(IPTp-SP) and long-lasting insecticide nets (LLINs), their use is hindered by several challenges. This study, therefore, assessed factors associated with utilisation of malaria preventive services (MPS) among pregnant women attending primary healthcare centres in Ile-Ife, Nigeria, using a mixed-method approach.
Methods: This was a mixed-method cross-sectional study design conducted among 200 pregnant women in ten selected healthcare facilities across two Local Government Areas (LGAs) of Ile Ife, Nigeria. While the quantitative data was collected from pregnant women using a semi-structured adapted questionnaire, qualitative data was collected from health workers and pregnant women using key informant interviews (KIIs) and focused group discussions (FGDs), respectively. Quantitative data was analysed using SPSS version 25.0, with logistic regression used to determine the factors influencing utilisation of LLINs and IPTp-SP. Thematic analysis of qualitative data was conducted using ATLAS.ti.
Results: Less than half (34%) of the respondents had good knowledge of malaria preventive services (MPS). While 62.5% of the respondents owned LLINs, only 47.5% reported current utilisation. Utilisation of at least one dose of IPTp-SP was at 50.8% and 7% for three or more doses. The multivariable analysis showed a statistically significant association between IPTp-SP uptake and occupation, good knowledge of malaria preventive services and gravidity. Factors that influenced utilisation of MPS include out-of-stock commodities, lack of money, late and irregular ANC attendance due to insufficient funds for transportation, the distance to healthcare facilities, and pregnant women's preference for visiting mission houses (faith-based homes where spiritual and maternity services are provided) over attending antenatal care (ANC), and insufficient training of healthcare providers.
Conclusions: Modalities to maintain constant availability of malaria preventive commodities at ANC clinics should be put in place. In addition to the conventional awareness programmes, optimal utilisation of MPS can be achieved through the integration of unconventional healthcare providers such as faith-based and traditional birth attendants into malaria in pregnancy preventive initiatives. Also, educational interventions and continuous health workers training are crucial.
Keywords: Intermittent preventive treatment in pregnancy; Long lasting insecticide nets; Malaria in pregnancy; Utilisation.
© 2026. The Author(s).