Acceptability of coupling intermittent preventive treatment in infants with the expanded programme on immunization in...

Area of Science:

• Global Health
• Malaria Control
• Pediatric Public Health

Background:

• Intermittent preventive treatment in infants (IPTi) with sulphadoxine-pyrimethamine (SP) is a WHO-recommended malaria control strategy in Africa.
• IPTi involves administering SP alongside routine infant immunizations for children under one year old.

Purpose of the Study:

• To analyze the acceptability of IPTi among communities and healthcare staff in pilot implementation areas.
• To understand perceptions and attitudes towards IPTi when integrated with routine immunization schedules.

Main Methods:

• Qualitative study employing direct observation, in-depth interviews (IDIs), and focus group discussions (FGDs).
• Conducted in Benin, Madagascar, and Senegal during IPTi pilot phases.
• Data analysis utilized NVivo7 software after transcription.

Main Results:

• Communities demonstrated good knowledge of malaria but did not always prioritize health centers for treatment.
• Both communities and health workers showed highly positive perceptions and attitudes towards IPTi.
• A key factor in acceptability was the misconception that SP prevents post-vaccinal fever; no refusals or negative rumors were observed.
• IPTi integration did not negatively impact attitudes towards other malaria control methods.
• Healthcare decision-making regarding children is shifting towards mothers, particularly educated and financially independent ones.

Conclusions:

• IPTi is highly acceptable to both healthcare providers and communities, with synergistic acceptance when linked to routine immunizations.
• Addressing the misconception that SP alleviates fever is crucial for successful large-scale IPTi implementation.
• The evolving role of mothers in healthcare decisions may influence future public health intervention uptake.