Using equity lens to explore Malaria Intermittent Preventive Treatment in Nigeria: A Qualitative study

Abstract Background : Sulphadoxine pyrimethamine (SP) used as a preventive treatment for malaria is low among pregnant women in Nigeria. However, there is limited evidence on the barriers and facilitators of intermittent preventive treatment (IPTp) use in pregnant women. Thus, this study aimed to explore the barriers and facilitators of IPTp use among pregnant women in Kano state, Nigeria.Methods: This qualitative study used a conventional content analysis method. Purposeful sampling strategy was used to select study participants. A total of 14 key informant interviews were conducted with policy makers, malaria experts and health care providers. Three focus group discussions (FGD) were also conducted among pregnant women. Furthermore, separate three FGDs were conducted among husbands whom were selected using opportunistic maximum variation sampling method. The data were analyzed with MaxqDA 10 software which was used to develop the categories, subcategories and themes.Results: A total of five main categories, 13 subcategories, and 17 themes were identified. Malaria policy implementation, antenatal care attendance, accessibility of intermittent preventive treatment in the communities, strengthening IPTp service delivery were the main facilitators of IPTp use. However, political reluctance, high population density, inadequate budget to implement IPTp related policies were the main barriers of IPTp use.Conclusion: This study revealed key barriers and facilitators of the use of Intermittent preventive treatment using Sulphadoxine pyrimethamine. Our study findings suggest that any strategy for improving the of IPTp use among pregnant women should focus on political reluctance, inadequate budget and strengthen the service delivery