Missed opportunities for intermittent preventive treatment for malaria in pregnancy in Nigeria: evidence from demographic and health survey in Nigeria 2013

Background : Malaria is of global health concern particularly among pregnant women. Nigeria contributes largely to global burden but coverage of Intermittent Preventive Treatment of malaria in pregnancy using Sulphadoxine pyrimethamine remains low. This study was conducted to determine the national situation of missed opportunity for IPTp-SP and attempted to look at correlates and predictors.Method: The study used secondary data analysis of the Nigeria Demographic Health Survey, 2013. Data on socio-demographics, ANC characteristics and IPTp-SP use during pregnancy among 6,910 women aged 15-49 years who delivered in the last two years with at least 4 ANC visits were analyzed. Missed opportunity for IPTp delivery was defined as an ANC visit where IPTp was not delivered as per the policy. Data was analyzed using SPSS version 21. Associations used Chi-square test and significant variables were fit into multivariate logistic regression model. All analyses were performed at 5% level of significance.Results: National prevalence for missed opportunity for IPTp-SP was high (73.4%). Predictors of missed opportunity are being of poorer, middle and richer wealth index (OR=0.737, CI 0.566-0.960); (OR=0.659, CI 0.521-0.833); (OR=0.686, CI 0.550-0.857), residence in South East OR=0.549, CI (0.415-0.726) and in the North West (OR=0.176, CI 0.133-0.232). Other predictors are having a primary and secondary education and presenting for the first ANC visit in the second trimester OR=0.739, p=0.024, CI (0.569-0.961).Conclusion: Missed opportunity for IPTp-SP was high. The need for stronger governmental commitment to upscale uptake of IPTp-SP by incorporating the knowledge of socio-economic, cultural and demographic barriers to accessing IPTp is paramount.Keywords: Missed opportunity, Malaria in pregnancy, Nigeria