What has recommended Antenatal Care utilisation got to do with optimal intake of IPTp-SP among rural women aged 15-49 in Nigeria?: A population-based surveys

Abstract

Abstract Background Missing the WHO-recommended ANC visits augments the risk of receiving a sub-optimal level of Intermittent-preventive treatment of malaria in pregnancy using Sulphadoxine-Pyrimethamine (IPTp-SP). Earlier reports found low utilisation of IPTp-SP among rural women in Nigeria. This study seeks to examine the relationship between the recommended ANC visits and optimal IPTp-SP uptake among rural women aged 15–49 in Nigeria. Methods We used data from the Female files of 2008, 2013, and 2018 Nigeria Demographic and Health Survey (NDHS) waves. A sample of 9,085 women aged 15 to 49 with pregnancy history and complete information about the variables of interest were included in our analysis. Optimal intake of IPTp-SP was the outcome variable in this study (i.e., receiving three or more doses of IPTp-SP during pregnancy). The main explanatory variable for this study was recommended ANC visits defined as having four or more ANC visits. At 95% confidence interval, logistic regression was conducted to examine the association between recommended ANC and optimal intake of IPTp-SP. Results Descriptively, 29% (n = 2,644, CI = 0.28–0.30) of the rural women aged 15–49 received the optimal level of IPTp-SP. Inferentially, we found a higher likelihood of optimal IPTp-SP intake among women who met the recommended ANC visits [aOR = 1.44, CI = 1.29–1.61] compared to women that did not. The rich exhibited a lower likelihood of optimal level of IPTp-SP intake [aOR = 0.81, CI = 0.70–0.94]. Muslims had a higher likelihood of receiving an optimal intake of IPTp-SP [aOR = 1.32, CI = 1.15–1.53]. South East residents had a higher likelihood of receiving an optimal level of IPTp-SP [aOR = 2.54, CI = 2.09–3.10], while the likelihood of optimal uptake of IPTp-SP reduced among residents in the North West [aOR = 0.46, CI = 0.40–0.54]. Conclusion Uptake of WHO-recommended optimal level of IPTp-SP was found to be low, which was linked mainly to the number of ANC visits. The results of this study call for implementing operational strategies, including Transforming IPT for Optimal Pregnancy in rural Nigeria. Appropriate prenatal care visits must be promoted to ensure accessibility of IPTp-SP in rural Nigeria. We suggest health education and awareness creation through mass media targeting women across the six geographical zones, particularly in North West Nigeria.