Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 4;23(1):315.
doi: 10.1186/s12884-023-05648-9.

Using Andersen's behavioral model of health care use for intermittent preventive treatment of malaria in pregnancy in Nigeria

Bola Lukman Solanke  1 , Rasheed Adebayo Yinusa  2 , Olaoye James Oyeleye  3 , Omolayo Bukola Oluwatope  3   4 , Benjamin Bukky Ilesanmi  3 , Tosin Olajide Oni  3
Affiliations

Using Andersen's behavioral model of health care use for intermittent preventive treatment of malaria in pregnancy in Nigeria

Bola Lukman Solanke et al. BMC Pregnancy Childbirth. .

Abstract

Background: Studies in Nigeria and elsewhere in sub-Saharan Africa (sSA) have explored factors influencing usage of intermittent preventive treatment of malaria in pregnancy (IPTp). Most studies, however, are not model or theory-based, which provides less satisfactory guidance to malaria control programming. This study fills the knowledge gap by adapting Andersen's behavioral model of health care use to IPTp usage in Nigeria.

Methods: This study adopted a cross-sectional design that utilized secondary data extracted from the 2018 Nigeria Demographic and Health Survey (NDHS). A weighted sample of 4,772 women who had given birth in the past year preceding the survey, was analyzed. Outcome variable was usage of IPTp, dichotomized into optimal or otherwise. Explanatory variables cut across individual and community levels and were divided into predisposing, enabling and need factors in line with the theoretical constructs of the Andersen model. Two multilevel mixed-effects logistic regression models were fitted to identify factors which influenced optimal usage of IPTp. Analyses were performed using STATA 14. Statistical significance was set at 5%.

Results: Realised level of optimal IPTp usage was 21.8%. Factors that either predispose or enable pregnant women to take optimal doses of IPTp were maternal education, being employed, being autonomous in their own healthcare, health insurance enrolment, partner education, receiving antenatal care in public health facilities, rural residence, being resident in northern geo-political zones, community literacy level and community perception of the consequences of malaria. Two significant need factors affecting optimal usage of IPTp were timing of the first antenatal care visit and sleeping under mosquito bed nets.

Conclusion: Optimal usage of IPTp is low among pregnant women in Nigeria. There is a need to devise additional public health educational programs promoting IPTp usage through the formation of Advocacy, Communication and Social Mobilisation (ACSM) in every ward in all local government areas, particularly in the rural and northern parts of the country. In addition, health planners should adopt the Andersen model for assessing key determinants of IPTp usage among childbearing women in Nigeria.

Keywords: Andersen model; Childbearing women; IPTp; Malaria in pregnancy; Nigeria.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

References

    1. Umemmuo MU, Agbogboroma CO, Iregbu KC. The efficacy of intermittent preventive therapy in the eradication of peripheral and placental parasitemia in a malaria-endemic environment, as seen in a tertiary hospital in Abuja, Nigeria. Int J Gynecol Obstet. 2020;148:338–343. doi: 10.1002/ijgo.13085. - DOI - PubMed
    1. World Health Organization. World malaria report 2020: 20 years of global progress and challenges. Geneva: World Health Organization; 2020. Retrieved 5th April, 2023 from https://apps.who.int/iris/handle/10665/337660
    1. Morakinyo OM, Balogun FM, Fagbamigbe AF. Housing type and risk of malaria among under- five children in Nigeria: evidence from the malaria indicator survey. Malar J. 2018;17:311. doi: 10.1186/s12936-018-2463-6. - DOI - PMC - PubMed
    1. National Malaria Elimination Programme (NMEP), National Population Commission (NPopC) National Bureau of Statistics (NBS), and ICF International. Nigeria Malaria Indicator Survey 2015. Abuja, Nigeria, and Rockville. Maryland, USA: NMEP, NPopC, and ICF International; 2016.
    1. World Health Organization . WHO policy brief for the implementation of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) Geneva: World Health Organization; 2016.