Bridging urban-rural disparities in malaria care during pregnancy in Senegal: evidence from household and health facility surveys.

IF 5.5 1区医学

Infectious Diseases of Poverty Pub Date : 2025-07-20 DOI:10.1186/s40249-025-01341-5

Yongsheng Jiang, Di Liang, Jinkou Zhao, Shailendra Prasad, Medoune Ndiop, Serigne Amdy Thiam, Ibrahima Diallo, Doudou Sene, Rose Mpembeni, Jiayan Huang

{"title":"Bridging urban-rural disparities in malaria care during pregnancy in Senegal: evidence from household and health facility surveys.","authors":"Yongsheng Jiang, Di Liang, Jinkou Zhao, Shailendra Prasad, Medoune Ndiop, Serigne Amdy Thiam, Ibrahima Diallo, Doudou Sene, Rose Mpembeni, Jiayan Huang","doi":"10.1186/s40249-025-01341-5","DOIUrl":null,"url":null,"abstract":"Background: Despite the World Health Organization's recommendations, the uptake of Intermittent Preventive Treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) in Senegal remains suboptimal, with disparities observed between urban and rural areas. More remains to be known about how malaria service readiness would affect the utilization of IPTp-SP.Methods: Data were obtained from seven annual rounds of Demographic and Health Surveys (DHS) and Service Provision Assessments (SPA) in Senegal from 2012 to 2019. Using sample domain linkage to link the databases at the regional level. A malaria service readiness index was calculated to quantify the malaria service delivery capacity within the service environment where women reside. The Heckman selection model was utilized to analyze the relationship between malaria service readiness and IPTp-SP utilization.Results: From 2012 to 2019, the average number of IPTp-SP doses received in Senegal was 1.66 (95% CI: 1.65-1.68), higher in urban areas [1.73 (95% CI: 1.71-1.75)] than rural areas [1.63 (95% CI: 1.62-1.65)]. Each one-point increase in malaria service readiness led to a rise of 0.251 doses in IPTp-SP. The significant interaction (Coef. = - 0.523, P < 0.001) indicated that women in rural areas received fewer doses of IPTp-SP (0.089) than in urban areas (0.612) for every unit increase in malaria service readiness.Conclusions: Linking household and health facility surveys revealed significant room for improvement in malaria service readiness and IPTp-SP utilization in rural areas in Senegal. For better IPTp-SP coverage, differential strategies are required for urban and rural settings. Urban areas need to enhance malaria service readiness, while rural areas should focus on improving service readiness alongside infrastructure and community engagement to bridge the urban-rural disparities.","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"71"},"PeriodicalIF":5.5000,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276681/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infectious Diseases of Poverty","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40249-025-01341-5","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Despite the World Health Organization's recommendations, the uptake of Intermittent Preventive Treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) in Senegal remains suboptimal, with disparities observed between urban and rural areas. More remains to be known about how malaria service readiness would affect the utilization of IPTp-SP.

Methods: Data were obtained from seven annual rounds of Demographic and Health Surveys (DHS) and Service Provision Assessments (SPA) in Senegal from 2012 to 2019. Using sample domain linkage to link the databases at the regional level. A malaria service readiness index was calculated to quantify the malaria service delivery capacity within the service environment where women reside. The Heckman selection model was utilized to analyze the relationship between malaria service readiness and IPTp-SP utilization.

Results: From 2012 to 2019, the average number of IPTp-SP doses received in Senegal was 1.66 (95% CI: 1.65-1.68), higher in urban areas [1.73 (95% CI: 1.71-1.75)] than rural areas [1.63 (95% CI: 1.62-1.65)]. Each one-point increase in malaria service readiness led to a rise of 0.251 doses in IPTp-SP. The significant interaction (Coef. = - 0.523, P < 0.001) indicated that women in rural areas received fewer doses of IPTp-SP (0.089) than in urban areas (0.612) for every unit increase in malaria service readiness.

Conclusions: Linking household and health facility surveys revealed significant room for improvement in malaria service readiness and IPTp-SP utilization in rural areas in Senegal. For better IPTp-SP coverage, differential strategies are required for urban and rural settings. Urban areas need to enhance malaria service readiness, while rural areas should focus on improving service readiness alongside infrastructure and community engagement to bridge the urban-rural disparities.

Abstract Image

查看原文本刊更多论文

缩小塞内加尔孕期疟疾护理方面的城乡差距：来自家庭和卫生设施调查的证据。

背景：尽管世界卫生组织提出了建议，但塞内加尔孕妇采用磺胺多辛-乙胺嘧啶间歇预防性治疗（IPTp-SP）的情况仍不理想，城乡地区之间存在差异。关于疟疾服务准备如何影响IPTp-SP的利用，还有待进一步了解。方法：收集塞内加尔2012 - 2019年7轮人口与健康调查（DHS）和服务提供评估（SPA）的数据。使用示例域链接在区域级别上链接数据库。计算了疟疾服务准备指数，以量化妇女居住的服务环境内提供疟疾服务的能力。采用Heckman选择模型分析疟疾服务准备与IPTp-SP利用之间的关系。结果：2012年至2019年，塞内加尔平均接受IPTp-SP剂量为1.66剂（95% CI: 1.65-1.68），城市地区[1.73剂（95% CI: 1.71-1.75）]高于农村地区[1.63剂（95% CI: 1.62-1.65）]。疟疾服务准备度每增加一个点，IPTp-SP就会增加0.251剂。显著的相互作用(Coef。结论：将家庭和卫生机构调查联系起来表明，塞内加尔农村地区在疟疾服务准备和IPTp-SP利用方面还有很大的改进空间。为了更好地覆盖IPTp-SP，需要针对城市和农村环境采取不同的战略。城市地区需要加强疟疾服务准备，而农村地区应注重改善服务准备以及基础设施和社区参与，以缩小城乡差距。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Infectious Diseases of Poverty INFECTIOUS DISEASES-

自引率

1.20%

发文量

368

期刊介绍： Infectious Diseases of Poverty is an open access, peer-reviewed journal that focuses on addressing essential public health questions related to infectious diseases of poverty. The journal covers a wide range of topics including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies and application. It also considers the transdisciplinary or multisectoral effects on health systems, ecohealth, environmental management, and innovative technology. The journal aims to identify and assess research and information gaps that hinder progress towards new interventions for public health problems in the developing world. Additionally, it provides a platform for discussing these issues to advance research and evidence building for improved public health interventions in poor settings.