title: Factors influencing dropout rate of intermittent preventive treatment of malaria during pregnancy.
abstract: BACKGROUND
  The burden of malaria in terms of morbidity and mortality is huge is Sub-Saharan Africa, particularly among pregnant women. Among the measures to curb down this burden include intermittent preventive treatment (IPT) and effective case management. These strategies were adopted by Ghana and implemented since 2003; however, there is still high dropout rate in IPT coverage. This study sought to investigate factors contributing to high dropout rate between IPT1 and IPT3 in the Tamale Metropolis, one of the health facilities with the highest IPT dropout rates in Ghana.
  
  
  METHODS
  Survey, in-depth interviews and short ethnographic techniques were conducted among pregnant women, antenatal care (ANC) health workers and heads of health facilities to investigate factors which account for dropout rate of intermittent treatment of malaria.
  
  
  RESULTS
  Shortage of sulphadoxine pyrimethamine (SP), inadequate supply of portable water for administration of SP, unavailability of IPT during outreach services, lack of knowledge by ANC staff about the dropout rate in their area of jurisdiction and poor attitude of some health workers were identified as barriers to achieving high IPT3 coverage.
  
  
  CONCLUSIONS
  Late ANC visit, provider and logistical barriers account for the women's missed opportunities to prevent malaria in pregnancy through IPT. Addressing the above barriers will contribute to saving lives and ensuring progress towards the goal of combating malaria as well as reducing maternal, neonatal and child mortalities.
authors.affiliation: Department of Population and Health, Private Mail Bag, University of Cape Coast, Cape Coast, Ghana. dokudavid@gmail.com.|School of Health Sciences, University of Tampere, Tampere, Finland. dokudavid@gmail.com.
authors.forename: David Teye
authors.initials: DT
authors.lastname: Doku
authors.affiliation: Metropolitan Health Directorate, Tamale, Ghana.
authors.forename: Mumuni Mukaila
authors.initials: MM
authors.lastname: Zankawah
authors.affiliation: Department of Population and Health, Private Mail Bag, University of Cape Coast, Cape Coast, Ghana.
authors.forename: Addae Boateng
authors.initials: AB
authors.lastname: Adu-Gyamfi
mesh_terms: D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008288:Malaria / Q000150:complications / Q000517:prevention & control*; D010352:Patient Dropouts; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000517:prevention & control*
chemical_list: D000962:Antimalarials
keywords: Dropout rate; Intermittent preventive treatment; Malaria in pregnancy