Effectiveness of the delivery of interventions to prevent malaria in pregnancy in Kenya
Identifieur interne : 001088 ( Main/Exploration ); précédent : 001087; suivant : 001089Effectiveness of the delivery of interventions to prevent malaria in pregnancy in Kenya
Auteurs : Stephanie Dellicour [Royaume-Uni] ; Jenny Hill [Royaume-Uni] ; Jane Bruce [Royaume-Uni] ; Peter Ouma [Kenya] ; Doris Marwanga [Kenya] ; Peter Otieno [Kenya] ; Meghna Desai [États-Unis] ; Mary J. Hamel [États-Unis] ; Simon Kariuki [Kenya] ; Jayne Webster [Royaume-Uni]Source :
- Malaria Journal [ 1475-2875 ] ; 2016.
Abstract
Coverage with malaria in pregnancy interventions remains unacceptably low. Implementation research is needed to identify and quantify the bottlenecks for the delivery and use of these life-saving interventions through antenatal clinics (ANC).
A cross-sectional study was carried out in ANC across nine health facilities in western Kenya. Data were collected for an individual ANC visit through structured observations and exit interviews with the same ANC clients. The cumulative and intermediate systems effectiveness for the delivery of intermittent preventive treatment (IPTp) and insecticide-treated nets (ITNs) to eligible pregnant women on this one specific visit to ANC were estimated.
Overall the ANC systems effectiveness for delivering malaria in pregnancy interventions was suboptimal. Only 40 and 53 % of eligible women received IPTp by directly observed therapy as per policy in hospitals and health centres/dispensaries respectively. The overall systems effectiveness for the receipt of IPTp disregarding directly observed therapy was 62 and 72 % for hospitals and lower level health facilities, respectively. The overall systems effectiveness for ITNs for first ANC visit was 63 and 67 % for hospitals and lower level facilities, respectively.
This study found that delivery of IPTp and ITNs through ANC was ineffective and more so for higher-level facilities. This illustrates missed opportunities and provider level bottlenecks to the scale up and use of interventions to control malaria in pregnancy delivered through ANC. The high level of clustering within health facilities suggest that future studies should assess the feasibility of implementing interventions to improve systems effectiveness tailored to the health facility level.
The online version of this article (doi:10.1186/s12936-016-1261-2) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s12936-016-1261-2
PubMed: 27091142
PubMed Central: 4835845
Affiliations:
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Liverpool School of Tropical Medicine, Liverpool, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool</wicri:regionArea><wicri:noRegion>Liverpool</wicri:noRegion></affiliation></author><author><name sortKey="Hill, Jenny" sort="Hill, Jenny" uniqKey="Hill J" first="Jenny" last="Hill">Jenny Hill</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool</wicri:regionArea><wicri:noRegion>Liverpool</wicri:noRegion></affiliation></author><author><name sortKey="Bruce, Jane" sort="Bruce, Jane" uniqKey="Bruce J" first="Jane" last="Bruce">Jane Bruce</name><affiliation wicri:level="3"><nlm:aff id="Aff2">Disease Control Department, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Disease Control Department, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Ouma, Peter" sort="Ouma, Peter" uniqKey="Ouma P" first="Peter" last="Ouma">Peter Ouma</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Malaria Branch, Kenya Medical Research Institute Centre for Global Health Research, Kisumu, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Malaria Branch, Kenya Medical Research Institute Centre for Global Health Research, Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Marwanga, Doris" sort="Marwanga, Doris" uniqKey="Marwanga D" first="Doris" last="Marwanga">Doris Marwanga</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Malaria Branch, Kenya Medical Research Institute Centre for Global Health Research, Kisumu, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Malaria Branch, Kenya Medical Research Institute Centre for Global Health Research, Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Otieno, Peter" sort="Otieno, Peter" uniqKey="Otieno P" first="Peter" last="Otieno">Peter Otieno</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Malaria Branch, Kenya Medical Research Institute Centre for Global Health Research, Kisumu, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Malaria Branch, Kenya Medical Research Institute Centre for Global Health Research, Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Desai, Meghna" sort="Desai, Meghna" uniqKey="Desai M" first="Meghna" last="Desai">Meghna Desai</name><affiliation wicri:level="2"><nlm:aff id="Aff4">Malaria Branch, Centers for Disease Control and Prevention, Atlanta, GA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Malaria Branch, Centers for Disease Control and Prevention, Atlanta</wicri:cityArea></affiliation></author><author><name sortKey="Hamel, Mary J" sort="Hamel, Mary J" uniqKey="Hamel M" first="Mary J." last="Hamel">Mary J. Hamel</name><affiliation wicri:level="2"><nlm:aff id="Aff4">Malaria Branch, Centers for Disease Control and Prevention, Atlanta, GA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Malaria Branch, Centers for Disease Control and Prevention, Atlanta</wicri:cityArea></affiliation></author><author><name sortKey="Kariuki, Simon" sort="Kariuki, Simon" uniqKey="Kariuki S" first="Simon" last="Kariuki">Simon Kariuki</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Malaria Branch, Kenya Medical Research Institute Centre for Global Health Research, Kisumu, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Malaria Branch, Kenya Medical Research Institute Centre for Global Health Research, Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Webster, Jayne" sort="Webster, Jayne" uniqKey="Webster J" first="Jayne" last="Webster">Jayne Webster</name><affiliation wicri:level="3"><nlm:aff id="Aff2">Disease Control Department, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Disease Control Department, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><series><title level="j">Malaria Journal</title><idno type="eISSN">1475-2875</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Coverage with malaria in pregnancy interventions remains unacceptably low. Implementation research is needed to identify and quantify the bottlenecks for the delivery and use of these life-saving interventions through antenatal clinics (ANC).</p></sec><sec><title>Methods</title><p>A cross-sectional study was carried out in ANC across nine health facilities in western Kenya. Data were collected for an individual ANC visit through structured observations and exit interviews with the same ANC clients. The cumulative and intermediate systems effectiveness for the delivery of intermittent preventive treatment (IPTp) and insecticide-treated nets (ITNs) to eligible pregnant women on this one specific visit to ANC were estimated.</p></sec><sec><title>Results</title><p>Overall the ANC systems effectiveness for delivering malaria in pregnancy interventions was suboptimal. Only 40 and 53 % of eligible women received IPTp by directly observed therapy as per policy in hospitals and health centres/dispensaries respectively. The overall systems effectiveness for the receipt of IPTp disregarding directly observed therapy was 62 and 72 % for hospitals and lower level health facilities, respectively. The overall systems effectiveness for ITNs for first ANC visit was 63 and 67 % for hospitals and lower level facilities, respectively.</p></sec><sec><title>Conclusion</title><p>This study found that delivery of IPTp and ITNs through ANC was ineffective and more so for higher-level facilities. This illustrates missed opportunities and provider level bottlenecks to the scale up and use of interventions to control malaria in pregnancy delivered through ANC. The high level of clustering within health facilities suggest that future studies should assess the feasibility of implementing interventions to improve systems effectiveness tailored to the health facility level.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s12936-016-1261-2) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Dellicour, S" uniqKey="Dellicour S">S Dellicour</name></author><author><name sortKey="Tatem, Aj" uniqKey="Tatem A">AJ Tatem</name></author><author><name sortKey="Guerra, Ca" uniqKey="Guerra C">CA Guerra</name></author><author><name sortKey="Snow, Rw" uniqKey="Snow R">RW Snow</name></author><author><name sortKey="Ter Kuile, Fo" uniqKey="Ter Kuile F">FO ter Kuile</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Desai, M" uniqKey="Desai M">M Desai</name></author><author><name sortKey="Ter Kuile, Fo" uniqKey="Ter Kuile F">FO ter Kuile</name></author><author><name sortKey="Nosten, F" uniqKey="Nosten F">F Nosten</name></author><author><name sortKey="Mcgready, R" uniqKey="Mcgready R">R McGready</name></author><author><name sortKey="Asamoa, K" uniqKey="Asamoa K">K Asamoa</name></author><author><name sortKey="Brabin, B" uniqKey="Brabin B">B Brabin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Walker, Pg" uniqKey="Walker P">PG Walker</name></author><author><name sortKey="Ter Kuile, Fo" uniqKey="Ter Kuile F">FO ter Kuile</name></author><author><name sortKey="Garske, T" uniqKey="Garske T">T Garske</name></author><author><name sortKey="Menendez, C" uniqKey="Menendez C">C Menendez</name></author><author><name sortKey="Ghani, Ac" uniqKey="Ghani A">AC Ghani</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Partnership, Roll Back Malaria" uniqKey="Partnership R">Roll Back Malaria Partnership</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Hill, J" uniqKey="Hill J">J Hill</name></author><author><name sortKey="Hoyt, J" uniqKey="Hoyt J">J Hoyt</name></author><author><name sortKey="Van Eijk, Am" uniqKey="Van Eijk A">AM van Eijk</name></author><author><name sortKey="D Ello Guyett, L" uniqKey="D Ello Guyett L">L D’Mello-Guyett</name></author><author><name sortKey="Ter Kuile, Fo" uniqKey="Ter Kuile F">FO ter Kuile</name></author><author><name sortKey="Steketee, R" uniqKey="Steketee R">R Steketee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ouma, P" uniqKey="Ouma P">P Ouma</name></author><author><name sortKey="Van Eijk, Am" uniqKey="Van Eijk A">AM van Eijk</name></author><author><name sortKey="Hamel, Mj" uniqKey="Hamel M">MJ Hamel</name></author><author><name sortKey="Parise, M" uniqKey="Parise M">M Parise</name></author><author><name sortKey="Ayisi, Jg" uniqKey="Ayisi J">JG Ayisi</name></author><author><name sortKey="Otieno, K" uniqKey="Otieno K">K Otieno</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hill, J" uniqKey="Hill J">J Hill</name></author><author><name sortKey="Kayentao, K" uniqKey="Kayentao K">K Kayentao</name></author><author><name sortKey="Achieng, F" uniqKey="Achieng F">F Achieng</name></author><author><name sortKey="Diarra, S" uniqKey="Diarra S">S Diarra</name></author><author><name sortKey="Dellicour, S" uniqKey="Dellicour S">S Dellicour</name></author><author><name sortKey="Diawara, Si" uniqKey="Diawara S">SI Diawara</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hill, J" uniqKey="Hill J">J Hill</name></author><author><name sortKey="Dellicour, S" uniqKey="Dellicour S">S Dellicour</name></author><author><name sortKey="Bruce, J" uniqKey="Bruce J">J Bruce</name></author><author><name sortKey="Ouma, P" uniqKey="Ouma P">P Ouma</name></author><author><name sortKey="Smedley, J" uniqKey="Smedley J">J Smedley</name></author><author><name sortKey="Otieno, P" uniqKey="Otieno P">P Otieno</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Webster, J" uniqKey="Webster J">J Webster</name></author><author><name sortKey="Kayentao, K" uniqKey="Kayentao K">K Kayentao</name></author><author><name sortKey="Bruce, J" uniqKey="Bruce J">J Bruce</name></author><author><name sortKey="Diawara, Si" uniqKey="Diawara S">SI Diawara</name></author><author><name sortKey="Abathina, A" uniqKey="Abathina A">A Abathina</name></author><author><name sortKey="Haiballa, Aa" uniqKey="Haiballa A">AA Haiballa</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Webster, J" uniqKey="Webster J">J Webster</name></author><author><name sortKey="Kweku, M" 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sortKey="Diawara, Si" uniqKey="Diawara S">SI Diawara</name></author><author><name sortKey="Haiballa, Aa" uniqKey="Haiballa A">AA Haiballa</name></author><author><name sortKey="Doumbo, Ok" uniqKey="Doumbo O">OK Doumbo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rowe, Sy" uniqKey="Rowe S">SY Rowe</name></author><author><name sortKey="Olewe, Ma" uniqKey="Olewe M">MA Olewe</name></author><author><name sortKey="Kleinbaum, Dg" uniqKey="Kleinbaum D">DG Kleinbaum</name></author><author><name sortKey="Mcgowan, Je" uniqKey="Mcgowan J">JE McGowan</name></author><author><name sortKey="Mcfarland, Da" uniqKey="Mcfarland D">DA McFarland</name></author><author><name sortKey="Rochat, R" uniqKey="Rochat R">R Rochat</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Van De Mortel, Tf" uniqKey="Van De Mortel T">TF van de Mortel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Forsberg, Bc" uniqKey="Forsberg B">BC Forsberg</name></author><author><name sortKey="Montagu, D" uniqKey="Montagu D">D Montagu</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Kenya</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Géorgie (États-Unis)</li></region><settlement><li>Londres</li></settlement></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Dellicour, Stephanie" sort="Dellicour, Stephanie" uniqKey="Dellicour S" first="Stephanie" last="Dellicour">Stephanie Dellicour</name></noRegion><name sortKey="Bruce, Jane" sort="Bruce, Jane" uniqKey="Bruce J" first="Jane" last="Bruce">Jane Bruce</name><name sortKey="Hill, Jenny" sort="Hill, Jenny" uniqKey="Hill J" first="Jenny" last="Hill">Jenny Hill</name><name sortKey="Webster, Jayne" sort="Webster, Jayne" uniqKey="Webster J" first="Jayne" last="Webster">Jayne Webster</name></country><country name="Kenya"><noRegion><name 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HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:27091142" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a SidaSubSaharaV1
| This area was generated with Dilib version V0.6.32. |  |