FACTORS INFLUENCING THE UPTAKE OF INTERMITTENT PREVENTIVE TREATMENT OF MALARIA IN PREGNANCY AMONG PREGNANT WOMEN ATTENDING ANTENATAL CLINIC AT PLATEAU STATE SPECIALIST HOSPITAL

TOPIC IS SUITABLE FOR:
1-Department of Public Health
2-Department of Nursing Science
3-Department of Community Health
4-Department of Midwifery

TOPIC: FACTORS INFLUENCING THE UPTAKE OF INTERMITTENT PREVENTIVE TREATMENT OF MALARIA IN PREGNANCY AMONG PREGNANT WOMEN ATTENDING ANTENATAL CLINIC AT PLATEAU STATE SPECIALIST HOSPITAL

TABLE OF CONTENT
Abstract
CHAPTER ONE: INTRODUCTION
1.1 Background of the Study 
1.2 Statement of the Problem 
1.3 Objective of the Study
1.4 Research Questions
1.5 Significance of the Study
1.6 Scope of the Study 
1.7 Definition of Terms  
CHAPTER TWO: REVIEW OF LITERATURE
2.1 Conceptual Review
2.2 Theoretical Framework 
2.3 Empirical Review 
2.4 Summary of Literature Review
CHAPTER THREE: METHODOLOGY    
3.1 Research Design    
3.2 Research Setting         
3.3 Target population                                  
3.4 Sample size 
3.5 Sampling technique    
3.6 Instruments for data collection     
3.7 Validity and Reliability of Instrument
3.8. Pilot Study    
3.9 Method of data collection 
3.10 Method of data analysis     
CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS
4.0 Introduction
4.1 Data Presentation
4.2 Demographic Analysis 
4.3 Analysis of the level of awareness of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) among pregnant women attending antenatal clinic at Plateau State Specialist Hospital.
4.4 Analysis of the extent of uptake of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) among pregnant women attending antenatal clinic at Plateau State Specialist Hospital.
CHAPTER FIVE: DISCUSSION OF FINDINGS
5.1 Discussion of Findings    
5.2 Implications of findings to nursing                            
5.3 Limitations of the study                            
5.4 Summary of the study 
5.5 Conclusion 
5.6 Recommendations  
5.7 Suggestions for further studies
References
Appendix

ABSTRACT 
This study was carried out to examine the factors influencing the uptake of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) among pregnant women attending antenatal clinic at Plateau State Specialist Hospital. The study was specifically carried out to assess the level of awareness of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) among pregnant women attending antenatal clinic at Plateau State Specialist Hospital, determine the extent of uptake of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) among pregnant women attending antenatal clinic at Plateau State Specialist Hospital, examine the socio-demographic factors influencing the uptake of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) among pregnant women attending antenatal clinic at Plateau State Specialist Hospital and ascertain the barriers affecting the uptake of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) among pregnant women attending antenatal clinic at Plateau State Specialist Hospital. The study employed the descriptive survey research design. A total population of 250 pregnant women attending antenatal clinic at Plateau State Specialist Hospital was considered for the study, while a sample size of 154 respondents was determined using Taro Yamane formula and selected using multi-stage sampling technique involving stratified and convenience sampling methods. The questionnaire was used for data collection, while the data collected were analyzed using frequency tables, percentages and multiple regression analysis. A validated sample size of 139 respondents was used for the final analysis. From the responses obtained and analyzed, the findings revealed that pregnant women had a moderate level of awareness and uptake of IPTp. The study also showed that socio-demographic factors significantly influenced the uptake of IPTp with R = 0.672, R² = 0.452, F = 15.384, P = 0.000, with educational level having the highest influence at β = 0.337. Likewise, the study further revealed that barriers such as inadequate knowledge, long waiting time, unavailability of IPTp drugs, cost-related concerns and accessibility issues affected the effective uptake of IPTp among pregnant women. The study therefore recommends that healthcare providers should intensify health education on IPTp, while government and health authorities should ensure consistent availability of IPTp medications and improve the quality and accessibility of antenatal services.
Keywords: Intermittent Preventive Treatment of Malaria in Pregnancy, IPTp, Uptake, Pregnant Women, Antenatal Clinic.

CHAPTER ONE
INTRODUCTION (Preview)
1.1 Background of the Study
Maternal health is a crucial part of Public Health around the world and it is the health of a woman during pregnancy, birth and postpartum. Maternal health improvement was identified as a key intervention to minimize preventable maternal and neonatal complications in developing health systems(Ogba et al (2022). Pregnant women are supported through a series of planned visits to monitor the course of their pregnancy and to support preventive measures and fetal wellbeing. Darteh et al (2021) found that improved maternal health care delivery improved the disease prevention outcomes among the pregnant population in endemic areas. Malaria is still a significant issue in maternal health in tropics. Akpa et al (2022) reported that embedding preventive health care in maternal care boosted maternal survival indicators and health system responsiveness. This cascade of care adds to better health outcomes for populations and sustainable maternal wellbeing throughout health facilities in resource-limited environments.
Intermittent preventive treatment of malaria in pregnancy involves giving a full therapeutic course of anti-malarial drugs at regular intervals throughout pregnancy to avoid malaria infection as well as malaria related complications. According to Peters & Naidoo (2022), the IPTp as a protective intervention during pregnancy was a significant intervention recommended in malaria endemic areas. According to Koita et al (2024), the pregnant woman's immune system is altered by the Plasmodium infection, leading to malaria in pregnancy and impacting fetal development outcomes. Kumah et al (2022) pointed out that the use of preventive pharmacologic interventions in the prenatal period had a positive effect on maternal haematological parameters and neonatal outcomes. Ladan et al (2026) said integration in routine ANC services improved continuity of ANC services delivery systems. This preventive measure helps in the reduction of malaria related complications and helps in the protection of maternal health during gestation in an environment of continually improving health care delivery in malaria-endemic areas.
A number of behavioural, socio-economic and health system factors contribute to uptake of intermittent preventive treatment of malaria in pregnancy (IPTp) among pregnant women. Akwuruoha et al (2025) found that knowledge and awareness of IPTp had a significant impact on adherence to recommended dosage schedule during the Antenatal Care. Orji et al (2022) found that higher education and health information exposure positively affected pregnant women's acceptance of preventive malaria interventions. Chukwuanukwu et al (2025) reported the presence of cultural beliefs and misconceptions about the use of antimalarial drugs, which affect their utilisation in some of the communities. Akpa et al (2022) reported that quality of counselling by health care providers and efficiency of the service delivery influenced adherence to IPTp guidelines. Consistent uptake of IPTp over time improves the coverage of antenatal care services, affordability of care and availability of recommended drugs over time will also determine the accessibility of antenatal services across population groups attending health facilities in endemic areas.
Malaria is still a public health problem in Nigeria, especially among pregnant women who need to be provided with simple yet structured interventions during Antenatal Care within health facilities. Improved access to preventive interventions at routine antenatal care (ANC) services was attributed to strengthening maternal health services (Ogba et al 2022). In malaria-endemic areas, Ladan et al (2026) found that incorporating malaria prevention services into antenatal clinics improved continuity of maternal health-care provision. Akpa et al (2022) noted that good antenatal counseling and arrangements of services enhanced uptake of maternal preventive interventions. Antenatal services are rendered to various populations of pregnant women in a tertiary health care institution that is involved in maternal wellbeing programmes in Plateau State Specialist Hospital. This allows for the delivery of preventive malaria interventions during pregnancy, and provides opportunities for consistent engagement during pregnancies, that will support the national maternal health strategy and help improve health outcomes across populations throughout the health care system generally.

1.2 Statement of the Problem
Malaria in pregnancy is a major issue of maternal health care provision in malaria endemic areas, especially in regions of high transmission in sub-Saharan Africa. Intermittent preventive treatment in pregnancy was stated by Peters & Naidoo (2022) to be globally recommended malaria prevention strategy to reduce malaria-related complications among pregnant women. Despite effective interventions, infection during pregnancy remained a threat to the health of mothers and fetuses, explained Koita et al (2024). To reinforce maternal and neonatal wellbeing, health systems have thus developed preventive approaches which are integrated into routine antenatal care services. Ladan et al (2026) explained that adding IPTp to ANC programmes enhanced the provision of prevention care and promoted maternal health across different endemic areas.
Although IPTp has been incorporated into antenatal care services, uptake of IPTp among pregnant women has been uneven and falls shy of the recommended targets in many endemic areas. There is need to achieve high coverage of IPTp to significantly reduce malaria burden in pregnancy, but the level of coverage was not always as desired reported Akpa et al (2022). Orji et al (2022) found that while there was awareness of malaria prevention, factors related to behaviour and health systems affected adherence to recommended IPTp doses. Barriers to complete adherence to IPTp guidelines included gaps in knowledge, cultural perceptions, and service delivery challenges, as identified by Chukwuanukwu et al (2025). While it is hoped that all eligible pregnant women will receive full doses of IPTp during antenatal visits, the current utilization of IPTp during pregnancy shows that there is still a long way to go in closing the gap between the IPTp policy and practice.
The continued significant gap between IPTp coverage and uptake indicates there are specific healthcare contexts where important contributing factors are still poorly understood. Past research identified general factors determining the use of IPTp, but there is a need to explore forces influencing the service delivery at the facility level, patients' characteristics and contextual factors. Although knowledge and health system factors have been identified as significant factors influencing uptake of IPTp, Akwuruoha et al (2025) found that contextual differences between health facilities had an impact on uptake. This leaves a gap in knowledge about the functioning of these factors among pregnant women attending antenatal clinics in tertiary health facilities like Plateau state Specialist Hospital. Hence, this study aims to evaluate the factors associated with IPTp uptake among pregnant women at PSSH, antenatal clinic to provide evidence for better maternal health interventions.
1.3 Objectives of the Study
The main purpose of this study is to investigate the factors influencing the uptake of intermittent preventive treatment of malaria in pregnancy among pregnant women attending antenatal clinic at Plateau State Specialist Hospital. The specific objectives of the study seek:
1.Assess the level of awareness of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) among pregnant women attending antenatal clinic at Plateau State Specialist Hospital.
2.Determine the extent of uptake of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) among pregnant women attending antenatal clinic at Plateau State Specialist Hospital
3.Examine the socio-demographic factors influencing the uptake of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) among pregnant women attending antenatal clinic at Plateau State Specialist Hospital. 
4.Examine the barriers affecting the uptake of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) among pregnant women attending antenatal clinic at Plateau State Specialist Hospital.
OTHER PARTS OF CHAPTER ONE INCLUDE:
1.4 Research Questions
1.5 Significance of the Study
1.6 Scope of the Study
1.7 Operational Definition of Terms 

CHAPTER TWO
REVIEW OF LITERATURE (Preview)
This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps. This chapter, therefore, focuses on the concept of malaria in pregnancy, the concept of intermittent preventive treatment of malaria in pregnancy, prevalence of malaria in pregnancy, uptake of intermittent preventive treatment of malaria in pregnancy, factors influencing the uptake of intermittent preventive treatment of malaria in pregnancy, and barriers to the uptake of intermittent preventive treatment among pregnant women attending antenatal clinic at Plateau State Specialist Hospital. The chapter covers the following subheadings:
2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review
2.4 Summary of Literature Review

CHAPTER THREE
METHODOLOGY (Preview)
Research Design: The study adopted a descriptive research design.
Population of the Study: The population of the study comprises pregnant women attending antenatal clinic at Plateau State Specialist Hospital, Jos.
Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 154 participants.
Sampling Technique: The study employed a multi-stage sampling technique involving stratified, proportional allocation, and convenience sampling procedures to select the individual respondents.
Research Instrument: The study utilized a structured questionnaire as the instrument for data collection.
Methods of Data Analysis: The collected data were analyzed using frequencies and percentages to summarize and present the demographic characteristics of the respondents and their responses. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) and presented in tables, charts, and graphs.

CHAPTER FOUR; DATA PRESENTATION AND ANALYSIS
MAJOR FINDINGS (Preview)
The analysis results were presented in tables. Based on the results obtained from the analysis, the following findings are made:

i. The study found that pregnant women attending antenatal clinic at Plateau State Specialist Hospital have a high level of awareness of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp), as evidenced by 69.7% of respondents who agreed that they were aware of IPTp as a preventive treatment against malaria during pregnancy. 

ii. The study found that the uptake of IPTp among pregnant women attending antenatal clinic at Plateau State Specialist Hospital was relatively high, as 60.4% of respondents agreed that they had received the recommended doses of IPTp during their current pregnancy, while 66.2% consistently attended antenatal clinics where IPTp services were provided.

iii. The study found that socio-demographic factors significantly influenced the uptake of IPTp among pregnant women, as evidenced by an R-value of 0.672 and an R² value of 0.452, indicating that 45.2% of the variation in IPTp uptake was explained by the selected socio-demographic variables. The corresponding regression analysis showed an F-value of 15.384 and a p-value of 0.000 (p < 0.05). Age (β = 0.264, p = 0.001), marital status (β = 0.172, p = 0.030), educational level (β = 0.337, p = 0.000), occupation (β = 0.151, p = 0.035), parity (β = 0.219, p = 0.007), and gestational age (β = 0.193, p = 0.013) significantly influenced IPTp uptake, while religion had no significant influence (β = 0.089, p = 0.199).

iv. The study found that several barriers affected the uptake of IPTp among pregnant women, including inadequate knowledge of its benefits, long waiting times, inadequate counselling, and unavailability of IPTp drugs at health facilities. Specifically, 62.6% of respondents agreed that long waiting times and inadequate counselling could reduce IPTp uptake, while 61.9% agreed that unavailability of IPTp drugs could hinder pregnant women from completing the recommended doses.

CHAPTER FIVE:  DISCUSSION OF FINDINGS
This chapter covers the following outline:
5.1 Discussion of Findings  
5.2 Implication of the Findings
5.3. Limitations of the Study
5.4 Summary 
5.5 Conclusion
5.6 Recommendations
5.7 Suggestions for Further Studies

UPLOADED BY MIRACLE