Compliance with Intermittent Preventive Treatment Against Malaria in Pregnancy: Role of Health Center Quality and Accessibility in a Beninese Semi Urban Area

Abstract

Background: In a context of low coverage (around 40%) of malarial intermittent preventive treatment in pregnant women in republic of Benin, we investigated the implication of health center quality and accessibility factors on the compliance with IPTp. Methods: In a cross-sectional study conducted from October 2017 to February 2018 in southern Benin, 422 women, pregnant in the last trimester or who gave birth less than a month ago were included. Conditions of access to the health center and factors related to the quality of services at the health center were collected. To search for associated factors, univariate analysis were performed using Chi2 (or Fisher’s) and Student’s test. Logistic regression model was fitted for multivariate analysis. Results: Rates of IPTp intake were 36.49%, 26.78% and 11.14% respectively for first, second and third doses. Two factors increased the probability of taking IPT: travel cost (OR=2.57 [1.36; 3.92]) and quality of reception at health center (OR=1.93 [1.27; 2.64]). Conversely, the increase in travel time from home to health center was associated with a lower probability of taking IPT (OR=0.91 [0.85; 0.98]). Conclusion: This study highlighted the need to take into account the improvement of the socioeconomic level of women and the improvement of the quality of services in health centers in order to achieve better coverage of IPT taking in pregnant women. Strengthening the health system in developing countries, in particular by recruiting health workers and training them, is beneficial.