Utilization and The Factors Associated with the uptake of Intermittent Preventive Treatment of Malaria in Pregnancy in Nambale Sub-County Hospital, Kenya

Background Malaria remains a significant public health problem globally, with highest morbidity and mortality reported in sub Saharan Africa. In 2022, 12.7 million (36%) Malaria in Pregnancy (MiP) cases in Sub Saharan Africa and 27% were reported from East Africa. In Kenya, 4,080,441 malaria cases and 5% MiP cases reported. Busia County, Kenya, reported 341,886 malaria cases and 22% MiP cases. WHO recommends administering intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) to prevent MIP in malaria-endemic zones. The objective of the study was to determine proportion of pregnant women utilizing IPTp-SP 3 and describe factors influencing utilization of IPTp-SP 3. Methods A cross-sectional study was employed, pregnant women of nine months, aged 14–49 years were interviewed, using questionnaires on Kobo-collect. The dependent variable was the uptake of three doses of IPTp-SP, with sociodemographic, health facility and individual factors as the independent variables. Chi square test was used in bivariate analysis to determine association between independent variables and dependable variables, variable with p value of ≤ 0.2, were subjected to multivariable logistic regression analysis to identify significant factors (variables with p value of ≤ 0.05) Results 384 pregnant women were interviewed, 90% resided in rural areas; 93% aware of IPTp use, 68% were married, 67% unemployed, 60% utilized IPTp-SP3 and 47% had secondary education. In the bivariate analysis, participant age 21–30 years {cOR = 2.34, 95% CI = 1.4–3.7}, belief in > 3 doses of IPTp preventing MiP {cOR = 3.09, 95% CI = 1.5–6.2}and having tertiary education {cOR = 2.71, 95% CI = 1.4–5.1} were associated with uptake of ≥ 3doses of IPTp. On multivariable logistics regression analysis, attendance of ANC at least 4 times {aOR = 8.42, 95% CI = 4.4–16.0} and uptake of IPTp-SP at 14–17 gestation weeks {aOR = 7.79, 95% CI = 3.2–18.7} independently associated with optimal utilization of IPTp (IPTp-SP3). Conclusion A sub-optimal IPTp-SP 3 utilization (60%) way below WHO target of 80%. ≥4ANC attendance and first IPTp-SP uptake at 14–17 gestation weeks were independently associated with optimal utilization of IPTp. Recommendation: The Maternal and Child Health personnel to follow up all pregnant women attending ANC at their facility to ensure ANC adherence of X4 and take ≥ 3doses of IPTp.