Knowledge, Attitude and Practice of Current Recommendation of Intermittent Preventive Treatment in Pregnancy among Healthcare Workers in Rural Communities in Abia State, Nigeria

Abstract

Background: The administration of sulfadoxine-pyrimethamine as part of Intermittent Preventive Treatment during Pregnancy (IPTp) continues to play a vital role in minimizing malaria-related health complications among expectant mothers. However, optimal implementation is largely dependent on healthcare workers' knowledge, attitude, and Practice (KAP), particularly in rural settings where malaria burden is high and healthcare access is limited. Objectives: To evaluate healthcare workers' knowledge, attitudes, and practices regarding the current WHO guidelines for Intermittent Preventive Treatment in pregnancy (IPTp) within selected rural areas of Abia State, Nigeria, and to determine the factors influencing successful implementation. Materials and Methods: A descriptive cross-sectional survey was carried out between June and October 2024, involving 422 healthcare professionals delivering antenatal services at primary and secondary healthcare centers in three deliberately selected rural Local Government Areas. A multistage sampling approach was employed to recruit participants, and data were obtained through structured, pretested, self-administered questionnaires. Statistical evaluation was performed using SPSS version 26, employing descriptive statistics, chi-square analyses, and logistic regression. Results were considered statistically significant at a p-value less than 0.05. Results: Among the 422 respondents, 69.2% demonstrated adequate knowledge of IPTp, 74.4% had a positive attitude, and 65.4% exhibited good Practice. Awareness of IPTp (93.6%) and correct identification of SP as the drug of choice (84.4%) were high. However, only 59.9% administered SP under directly observed therapy (DOT), and 51.9% adhered to monthly dosing. Barriers identified included inadequate SP supply (58.5%) and lack of training (45.5%). Significant associations were found between KAP and variables such as age, profession, facility type, and training on malaria in pregnancy, and years of experience (p < 0.05). Positive correlations existed among knowledge, attitude, and practice scores (p < 0.01). Conclusion: While healthcare workers in rural Abia State show relatively high awareness and favorable attitudes toward IPTp, practice gaps persist, largely due to supply chain and training deficiencies. Targeted interventions such as regular capacity building and improved drug logistics are essential to strengthen IPTp implementation.