Abstract

Background: Malaria is a major public health burden that is endemic in sub-Saharan Africa. Malaria infestation during pregnancy can be deleterious not only to the mother but also the fetus. The objective of this study was to evaluate malaria programme and the utilization of malaria commodities between 2014 and 2018 in Ondo State, Southwest Nigeria.

Materials and methods: This study analyzed malaria-related indicators tracked on a routine basis in the state of Ondo, Nigeria. A retrospective cohort analysis of a retrieved from the District Health Information Management version 2.0 (DHISv2.0) database was conducted. Data was analyzed using Stata 13 statistical software. The prevalence of utilization of ANC and the proportions of pregnant women accessing malaria commodities were assessed using frequency tabulation, means, and analysis of variance (ANOVA). Correlation coefficient was for association among some variables was employed.

Results: The mean proportion of women who had at least 1 ANC visit during the period of study was 34.3±3.9, highest in 2017 (39.1±14.8) and lowest in 2018 (26.8±12.1). The overall mean proportion of women who had at least 4 ANC visits during pregnancy was 20.3±14.1 (F-statistics=2.88, P-value=0.03), highest in 2015 (25.9±18.9) and lowest in 2018 (14.0±10.6) and the mean proportion of those who had at least 1 ANC visit before 20 weeks of pregnancy was 38.1±10.0 (F-statistics=5.63, P-value=0.0005), highest in 2017 (45.4±10.7) and lowest in 2014 (32.6±9.1). During the study period, significant variations were observed in the mean proportion of pregnant women who received LLIN at first ANC visit (F-statistics=9.52, P-value=0.00001) and those who received IPTs at ANC revisit (F-statistics=5.17, P-value=0.0009) but not in the proportion of pregnant women with anemia. None of the indicators for malaria in pregnancy correlated with anemia rate during the study period. Geographical variations observed in the measured indicators were discussed.

Conclusion: This study observed disparity in proportion of pregnant women assessing ANC services and in the proportion of those that utilized malaria commodities from 2014 to 2018. Residential variances, and geographical locations were detected the consumption of ANC services. Areas farthest from the state capital, such as the Atlantic Ocean coastline in the south and the Savannah ecological zone in the north seemed to have low utilization of ANC. The State Malaria Elimination Program should be supported strongly in terms of technical and financial assistance to improve ANC service utilization throughout the State. The disparity in ANC accessibility in Ondo State will further reduce maternal and infant morbidity and mortality as well as improve the socio-economic living standards of the people.

Keywords

Antenatal care, Malaria in pregnancy, Indicators, District health information management, National health information management system, Geographical variations, Ondo State malaria elimination program, Analysis of variance, Federal ministry of health, Intermittent preventive treatment