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Assessing demand-side barriers to uptake of intermittent preventive treatment for malaria in pregnancy: a qualitative study in two regions of Uganda

Overview of attention for article published in Malaria Journal, November 2016
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Title
Assessing demand-side barriers to uptake of intermittent preventive treatment for malaria in pregnancy: a qualitative study in two regions of Uganda
Published in
Malaria Journal, November 2016
DOI 10.1186/s12936-016-1589-7
Pubmed ID
Authors

Christian Rassi, Kirstie Graham, Rebecca King, James Ssekitooleko, Patrobas Mufubenga, Sam Siduda Gudoi

Abstract

To prevent malaria infection during pregnancy in endemic areas in Africa, the World Health Organization recommends the administration of intermittent preventive treatment in pregnancy (IPTp) as part of the focused antenatal care package. However, IPTp uptake in most countries remains low despite generally high antenatal care coverage and increased efforts by governments to address known bottlenecks such as drug stock-outs. The study explored factors that continue to impede uptake of IPTp among women who attend antenatal care. This paper focuses on demand-side barriers with regard to accessibility, affordability and acceptability. The research was conducted in 2013/2014 and involved 46 in-depth interviews with four types of respondents: (i) seven district health officials; (ii) 15 health workers; (iii) 19 women who attended antenatal care; (iv) five opinion leaders. Interviews were conducted in Eastern and West Nile regions of Uganda. Data was analysed by thematic analysis. District health officials and health workers cited a range of barriers relating to knowledge and attitudes among pregnant women, including lack of awareness of pregnancy-related health risks, a tendency to initiate antenatal care late, reluctance to take medication and concerns about side effects of IPTp. However, women and opinion leaders expressed very positive views of antenatal care and IPTp. They also reported that the burden of travel and cost associated with antenatal care attendance was challenging, but did not keep them from accessing a service they perceived as beneficial. The role of trust in health workers' expertise was highlighted by all respondents and it was reported that women will typically accept IPTp if encouraged by a health worker. Given the positive views of antenatal care and IPTp, high antenatal care coverage and reported low refusal rates for IPTp, supply-side issues are likely to account for the majority of missed opportunities for the provision of IPTp when women attend antenatal care. However, to increase uptake of IPTp on the demand side, health workers should be encouraged to reassure eligible women that IPTp is safe.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 169 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 169 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 53 31%
Researcher 23 14%
Student > Bachelor 18 11%
Student > Postgraduate 8 5%
Student > Ph. D. Student 7 4%
Other 23 14%
Unknown 37 22%
Readers by discipline Count As %
Medicine and Dentistry 42 25%
Nursing and Health Professions 34 20%
Social Sciences 13 8%
Biochemistry, Genetics and Molecular Biology 5 3%
Pharmacology, Toxicology and Pharmaceutical Science 5 3%
Other 29 17%
Unknown 41 24%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 November 2016.
All research outputs
#14,279,821
of 22,899,952 outputs
Outputs from Malaria Journal
#3,979
of 5,581 outputs
Outputs of similar age
#176,526
of 311,298 outputs
Outputs of similar age from Malaria Journal
#55
of 87 outputs
Altmetric has tracked 22,899,952 research outputs across all sources so far. This one is in the 35th percentile – i.e., 35% of other outputs scored the same or lower than it.
So far Altmetric has tracked 5,581 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.8. This one is in the 24th percentile – i.e., 24% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 311,298 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 40th percentile – i.e., 40% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 87 others from the same source and published within six weeks on either side of this one. This one is in the 35th percentile – i.e., 35% of its contemporaries scored the same or lower than it.