The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68767

Rima Shretta, MSc¹, Nancy Nachbar, DrPH², Lonna B. Shafritz³, and Grace Adeya, MD¹. (1) Rational Pharmaceutical Management Plus, Management Sciences for Health, 4301 N Fairfax Drive, Suite 400, Arlington, VA 22203-1627, (2) Center for Applied Behavioral and Evaluation Research, Academy for Educational Development, 1825 Connecticut Avenue, NW, Washington, DC 20009, (3) CHANGE Project, Academy for Educational Development, 1875 Connecticut Ave, 9th floor, Washington, DC 20009, 202-884-8784, lshafrit@aed.org

Research has shown that periodic administration of sulphadoxine-pyrimethamine (SP) to pregnant women in malaria endemic areas has been associated with substantial reductions in low birth weight and anemia. The Ministry of Health in Senegal is considering introducing a policy recommending the administration of SP as Intermittent Preventive Therapy (IPT) to all pregnant women initially through a pilot intervention at selected sites.

A study to identify the barriers and facilitators for the implementation of IPT and insecticide treated nets (ITNs) through antenatal care facilities in Senegal was carried out in Guédiawaye and Kaolack districts in September 2002. The purpose was to obtain an understanding of the factors that may promote or inhibit the effective utilization of IPT and ITNs and contribute to designing and implementing effective interventions to achieve high coverage rates in the community. Qualitative research methods including in-depth interviews with providers, observation, in-depth interviews and focus group discussions with newly delivered mothers in community and pregnant women attending antenatal clinics were used.

The findings indicated high use of antenatal facilities and chloroquine chemoprophylaxis during pregnancy. The main barriers to IPT appeared to be related to concerns about SP safety and understanding of the protocol amongst the community and health providers. Barriers to ITN utilization included a lack of availability and counseling during antenatal encounters as well as concerns about insecticide safety. Training and behavior change communication should include rationale for the change in the strategy, information on SP safety, and the added efficacy of dual strategies of IPT and ITNs.

Learning Objectives:

• At the conclusion of the session, participants will be able to:
• 1. Describe the social and behavioral factors at the provider and community level as well as individual maternal factors that may affect decisions to give or take IPT and use ITNs
• 2. Understand and articulate the relative importance of these factors and how they may influence a decision to comply with the interventions including the identification of levels of influence and perceived authority.
• 3. Describe the programmatic implications of the findings and how they can be used to develop training guides and behavior change and communication interventions

Keywords: Reproductive Health, Behavioral Research

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.