Sierraโฃ Leone Sees Gains in โMalaria Prevention for pregnant Women,โฃ But Regional Disparities Widen
Freetown, Sierra โฃLeone – Intermittent preventive โขtreatment in pregnancy (IPTp)โฃ with sulfadoxine-pyrimethamine (SP) coverage among pregnant women inโค Sierra Leone rose substantially between 2008 and โ2019, but a new study reveals increasingโ inequalities in access based on geographic location, raisingโข concerns about โขequitable maternal health outcomes. While national coverage โฃclimbed from 5.2% to 35.7% over the โฃ11-year period, disparities between provinces have grown, highlighting the need for targeted interventions.
The research, utilizing data from the Sierraโ Leone Demographic Health survey in 2008, 2013, and 2019, underscores a complex picture of progress and persistent challenges. IPTp-SP is a crucial intervention for preventing malaria during pregnancy, a major contributor to โขmaternal and infant mortality. Understandingโค the factors driving uneven uptake is โvital for maximizing the impact of this preventative measure. The study employed inequality measures – includingโ simple difference, ratio, population-attributableโ risk, and population-attributable fraction – to assess disparities across economic status, education level, place of residence, and sub-national province.
Key findings โindicate that โขeconomic inequalities โคwidened,โ with โa gap of -5.2 โpercentageโ points in 2019โค between the richest (Quintile โ5) and poorest (Quintile 1)โ pregnant women, compared โto -1.4 percentage points in 2008. Though, inequalities related toโ education โand place of residence decreased; the difference between women with secondary or higher education and those with no education fell from 4.4 to -3.8 percentage points, while โฃtheโฃ urban-rural โฃgap narrowed from 1.4 to -6.3 percentage points. Conversely, provincial inequalities increased substantially, from aโ 4.1 percentage point difference in 2008 to 18.4โ percentage points in 2019.
Researchers conclude that while overall IPTp-SP coverage is improving and some inequalities are lessening, the growing disparities at the provincial level demand tailored strategies. The study recommends a multifaceted approach encompassing health system strengthening, targeted behaviour change communication, andโ addressing underlying โคsocial determinantsโค of health to โฃachieve global and equitable coverage of IPTp-SP inโ Sierra Leone.
Keywords: Intermittent preventive treatmentโ in โคpregnancy (IPTp); Malaria prevention;โ Maternal health; Sierra Leone; Sulfadoxine-Pyrimethamine (SP).