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Research article
Mahboubeh Parsaeian
Tehran University of Medical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1928-5424
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Sulphadoxine pyrimethamine using intermittent preventive treatment (IPTp-SP) for malaria prevention is recommended for all pregnant women at malaria endemic areas. However, there is limited evidence on the level of socioeconomic inequality in IPTp-SP use to prevent malaria in pregnant women in Nigeria. Thus, this study aimed to determine the level of socioeconomic inequality in IPTp-SP use among pregnant women and to decompose it into its contributing factors.
Methods: A secondary data analysis of Nigerian demographic and health survey of 2018 was conducted. A sample of 2,162 pregnant women aged between 15-49 years and had live birth in the past 2 years before the survey were included to this analysis. Participants were recruited based on two-stage cluster sampling method. Socioeconomic inequality was decomposed into its contributing factors by concentration index.
Result: The pregnant women who took at least one or more IPTp was 63.4%, while those who took two or more doses were 40.0 % and those who took three or more doses were 17%. Based on concentration index of 0.180 (p-value= <0.001, 95% CI: 0.176 to 0.183) and the Erreyger’s normalization concentration index 0.280 (p-value=<0.001, 95% CI: 0.251 to 0.309 IPTp utilization was pro-rich. The largest contributors to the inequality in IPTp uptake were wealth index (47.81%) and educational status (28.66%).
Conclusion: Our findings showed that IPTp use was pro-rich in Nigeria. Wealth index and educational status were the factors that significantly contributed to the inequality. The disparities could be reduced through IPTp service expansion by targeting pregnant women from low socioeconomic status.
Keywords
Malaria, Intermittent preventive treatment, Socioeconomic inequality, Decomposition analysis, Nigeria
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Received 15 Sep, 2020
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Review #1 received
Received 13 Sep, 2020
Reviewer #4 agreed
On 26 Aug, 2020
Reviewers invited
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Reviewer #1 agreed
On 25 Aug, 2020
Reviewer #2 agreed
On 25 Aug, 2020
Reviewer #3 agreed
On 25 Aug, 2020
Editor assigned
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On 12 Aug, 2020
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Learn more about In Review
Research article
Mahboubeh Parsaeian
Tehran University of Medical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1928-5424
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Public Health.
No community comments so far
Submission checks complete
On 24 Nov, 2020
Editorial decision: Accept
On 23 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 08 Nov, 2020
Review #1 received
Received 04 Nov, 2020
Review #2 received
Received 03 Nov, 2020
Review #3 received
Received 03 Nov, 2020
Reviewer #3 agreed
On 16 Oct, 2020
Editor assigned
On 15 Oct, 2020
Reviewers invited
Invitations sent on 15 Oct, 2020
Reviewer #1 agreed
On 15 Oct, 2020
Reviewer #2 agreed
On 15 Oct, 2020
Submission checks complete
On 14 Oct, 2020
Editor invited
On 14 Oct, 2020
Version 1
Posted 25 Aug, 2020
No comments provided
Editorial decision: Major revision
On 16 Sep, 2020
Review #3 received
Received 15 Sep, 2020
Review #2 received
Received 15 Sep, 2020
Review #1 received
Received 13 Sep, 2020
Reviewer #4 agreed
On 26 Aug, 2020
Reviewers invited
Invitations sent on 25 Aug, 2020
Reviewer #1 agreed
On 25 Aug, 2020
Reviewer #2 agreed
On 25 Aug, 2020
Reviewer #3 agreed
On 25 Aug, 2020
Editor assigned
On 13 Aug, 2020
Submission checks complete
On 12 Aug, 2020
Editor invited
On 12 Aug, 2020
First submitted
On 11 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
Background: Sulphadoxine pyrimethamine using intermittent preventive treatment (IPTp-SP) for malaria prevention is recommended for all pregnant women at malaria endemic areas. However, there is limited evidence on the level of socioeconomic inequality in IPTp-SP use to prevent malaria in pregnant women in Nigeria. Thus, this study aimed to determine the level of socioeconomic inequality in IPTp-SP use among pregnant women and to decompose it into its contributing factors.
Methods: A secondary data analysis of Nigerian demographic and health survey of 2018 was conducted. A sample of 2,162 pregnant women aged between 15-49 years and had live birth in the past 2 years before the survey were included to this analysis. Participants were recruited based on two-stage cluster sampling method. Socioeconomic inequality was decomposed into its contributing factors by concentration index.
Result: The pregnant women who took at least one or more IPTp was 63.4%, while those who took two or more doses were 40.0 % and those who took three or more doses were 17%. Based on concentration index of 0.180 (p-value= <0.001, 95% CI: 0.176 to 0.183) and the Erreyger’s normalization concentration index 0.280 (p-value=<0.001, 95% CI: 0.251 to 0.309 IPTp utilization was pro-rich. The largest contributors to the inequality in IPTp uptake were wealth index (47.81%) and educational status (28.66%).
Conclusion: Our findings showed that IPTp use was pro-rich in Nigeria. Wealth index and educational status were the factors that significantly contributed to the inequality. The disparities could be reduced through IPTp service expansion by targeting pregnant women from low socioeconomic status.
Figure 1
Figure 2
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