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Table 5 Opportunities for intervention to improve intermittent preventive therapy in pregnancy uptake

From: Perceptions of intermittent preventive treatment of malaria in pregnancy (IPTp) and barriers to adherence in Nasarawa and Cross River States in Nigeria

  Level of intervention
Barrier to IPTp uptake Individual Community Environment
Understanding of MiP Emphasize the importance and benefits of timely treatment of malaria with ACT, rather than herbal medicines to women and their families. Emphasize the importance and benefits of timely treatment of malaria with ACT, rather than herbal medicines to women and their families. Develop and disseminate effective job-aids for providers on focused ANC and MiP protocols.
Partner with CHWs to reach and inform women and their families on ACT.
Understanding of IPT Develop lower literacy information packets to explains dosage and timing for women given prescription for SP. Develop lower literacy information packets to explains dosage and timing for women given prescription for SP. Provide supportive health care supervision to ensure that providers and CHWs follow MiP protocols.
Costs of seeking care Emphasize lower cost of preventing malaria compared to treating malaria or complications (such as low birth weight infant) Emphasize lower cost of preventing malaria compared to treating malaria or complications (such as low birth weight infant) Ensure that only allowable fees are charged.
Waiting time Identify and promote specific day of the week as “malaria treatment day” to ensure attendance and speedy services delivery. Identify and promote specific day of the week as “malaria treatment day” to ensure attendance and speedy services delivery. Provide appropriate staffing to ensure timely services delivery on “malaria treatment day” and reduce waiting time.
Client-provider interaction Encourage women seeking MiP services to ask questions and interact with providers. Include messages encouraging women to ask providers questions in BCC campaigns Improve provider IPC skills through short, intensive training with role plays to enable providers to see patient’s perspectives.
Availability of SP on-site NA NA Improve supply-chain management. May require a more inclusive facility-level and mobile drug distribution processes.
Women, Families and Community Encourage women and families to see benefits rather than barriers to preventive MiP care seeking behaviours. Reinforce existing beliefs and behaviours to prevent and manage MiP Engage influential community members to encourage prevention and management of MiP