Jakub Kreuter, Michelle Cathorall, Saidah Mbooge

Intermittent Preventive Therapy Adherence Amongst Women in the Luwero District of Uganda and Relevant Policy Recommendations

Introduction

Intermittent preventive therapy adherence amongst women in the luwero district of uganda and relevant policy recommendations. Examine intermittent preventive therapy (IPTp) adherence among women in Uganda's Luwero District, its impact on malaria prevention, and key policy recommendations.

Abstract

Objectives: This study intends to provide an updated estimate on intermittent preventative therapy adherence in the Luwero district of Uganda. Study Design:  A cross-sectional study design was employed. In person interviews, using a structured questionnaire developed for this study, were used to collect data. Methods: Data were collected from a convenience sample of women from four villages in the Luwero District of Uganda. Questions were asked a loud in English and the responses recorded electronically in Qualtrics or on paper. Data from paper forms were entered into Qualtrics. Data were exported to SPSS for analysis.   Results: The results indicate that 91% percent of women interviewed received at least one dose of IPTp during their last pregnancy. Fifty-eight percent of the respondents received three or more doses of IPTp. While 42% of respondents reported contracting malaria when last pregnant.    Conclusion: IPTp3+ adherence appears to have increased amongst women in Uganda since the last nationwide study.

Review

This study addresses a critically important public health issue: adherence to Intermittent Preventive Therapy in pregnancy (IPTp) in the Luwero District of Uganda. Providing an updated estimate on adherence is highly relevant given the ongoing efforts to reduce maternal and neonatal malaria. The abstract's main finding, that IPTp3+ adherence appears to have increased since the last nationwide study, is an encouraging development, suggesting positive strides in public health interventions, with a high proportion (91%) of women receiving at least one dose during their last pregnancy. While a cross-sectional design is suitable for estimating prevalence, several methodological aspects presented in the abstract limit the confidence one can place in the findings. The use of a convenience sample from only four villages significantly restricts the generalizability of these results, making it difficult to draw conclusions applicable to the broader Luwero District or Uganda. A major concern is the method of data collection, where questions were asked aloud in English. In a rural Ugandan setting, this could introduce substantial language barriers, misunderstandings, or social desirability bias, potentially compromising the accuracy and validity of reported adherence. Furthermore, essential details such as the sample size, specific ethical considerations, and the exact statistical analyses performed are notably absent, hindering a comprehensive assessment of the study's rigor. The reported 58% adherence to three or more IPTp doses, though an improvement, indicates that nearly half of the women are not completing the recommended regimen. This, coupled with 42% of respondents reporting malaria during their last pregnancy, suggests that despite some level of IPTp uptake, many women remain vulnerable to the disease. The study's title promises "Relevant Policy Recommendations," but these are not articulated in the abstract. Based on the findings, such recommendations would likely need to focus on targeted interventions to bridge the gap between initial dose receipt and full adherence, perhaps by investigating barriers to completion. Future research should prioritize robust, representative sampling, employ culturally and linguistically appropriate data collection methods, and provide a more detailed account of the methodology to offer clearer, more actionable insights for public health policy.

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