Factors Affecting Providers' Delivery of Intermittent Preventive Treatment for Malaria in Pregnancy: A Five-country Analysis of National Service Provision Assessment Surveys.

摘要: Intermittent preventive treatment in pregnancy (IPTp) delivered during antenatal care (ANC) visits has been shown to be a highly efficacious and cost-effective intervention. Given the high rates of ANC attendance sub-Saharan Africa, current low IPTp coverage represents considerable missed opportunities. The objective this study was explore factors affecting provider’s delivery consultations. Data from five nationally representative service provision assessment surveys informed statistical analyses (Kenya, Namibia, Rwanda, Tanzania, Uganda; 2006-2010). Poisson regression models with robust/clustered standard errors were used estimate effect different determinants on 4,971 observed major modifiable were: 1) user-fees for medicines (relative risk (RR) = 0.76; 95% confidence intervals (95% CI): 0.62-0.93); 2) facilities having guidelines (RR = 1.12; CI: 1.01-1.24); 3) implemented as part their routine services offering (RR = 4.18; 1.75-10.01); 4) stock-outs sulphadoxine-pyrimethamine (RR = 0.40; 0.27-0.60); and, 5) providers received training (RR = 1.21; 1.09-1.35). Using population-attributable fraction, it estimated that addressing these barriers jointly could lead 31% increase intervention Of four potentially determinants, had largest potential impact. If proved cost-effective, dispensing should prioritized. Multifaceted approaches targeted areas and/or type least likely provide if Roll Back Malaria target 100% by 2015 is attained.