Bridging urban-rural disparities in malaria care during pregnancy in Senegal: evidence from household and health facility surveys
Abstract Background Despite the World Health Organization’s recommendations, the uptake of Intermittent Preventive Treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) in Senegal remains suboptimal, with disparities observed between urban and rural areas. More remains to be known about ho...
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BMC
2025-07-01
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| Series: | Infectious Diseases of Poverty |
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| Online Access: | https://doi.org/10.1186/s40249-025-01341-5 |
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| author | Yongsheng Jiang Di Liang Jinkou Zhao Shailendra Prasad Medoune Ndiop Serigne Amdy Thiam Ibrahima Diallo Doudou Sene Rose Mpembeni Jiayan Huang |
| author_facet | Yongsheng Jiang Di Liang Jinkou Zhao Shailendra Prasad Medoune Ndiop Serigne Amdy Thiam Ibrahima Diallo Doudou Sene Rose Mpembeni Jiayan Huang |
| author_sort | Yongsheng Jiang |
| collection | DOAJ |
| description | Abstract Background Despite the World Health Organization’s recommendations, the uptake of Intermittent Preventive Treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) in Senegal remains suboptimal, with disparities observed between urban and rural areas. More remains to be known about how malaria service readiness would affect the utilization of IPTp-SP. Methods Data were obtained from seven annual rounds of Demographic and Health Surveys (DHS) and Service Provision Assessments (SPA) in Senegal from 2012 to 2019. Using sample domain linkage to link the databases at the regional level. A malaria service readiness index was calculated to quantify the malaria service delivery capacity within the service environment where women reside. The Heckman selection model was utilized to analyze the relationship between malaria service readiness and IPTp-SP utilization. Results From 2012 to 2019, the average number of IPTp-SP doses received in Senegal was 1.66 (95% CI: 1.65–1.68), higher in urban areas [1.73 (95% CI: 1.71–1.75)] than rural areas [1.63 (95% CI: 1.62–1.65)]. Each one-point increase in malaria service readiness led to a rise of 0.251 doses in IPTp-SP. The significant interaction (Coef. = − 0.523, P < 0.001) indicated that women in rural areas received fewer doses of IPTp-SP (0.089) than in urban areas (0.612) for every unit increase in malaria service readiness. Conclusions Linking household and health facility surveys revealed significant room for improvement in malaria service readiness and IPTp-SP utilization in rural areas in Senegal. For better IPTp-SP coverage, differential strategies are required for urban and rural settings. Urban areas need to enhance malaria service readiness, while rural areas should focus on improving service readiness alongside infrastructure and community engagement to bridge the urban-rural disparities. Graphical abstract |
| format | Article |
| id | doaj-art-3048cb70d18b47f4ad4ddd8fb827f24a |
| institution | Kabale University |
| issn | 2049-9957 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Diseases of Poverty |
| spelling | doaj-art-3048cb70d18b47f4ad4ddd8fb827f24a2025-08-20T04:02:49ZengBMCInfectious Diseases of Poverty2049-99572025-07-0114111310.1186/s40249-025-01341-5Bridging urban-rural disparities in malaria care during pregnancy in Senegal: evidence from household and health facility surveysYongsheng Jiang0Di Liang1Jinkou Zhao2Shailendra Prasad3Medoune Ndiop4Serigne Amdy Thiam5Ibrahima Diallo6Doudou Sene7Rose Mpembeni8Jiayan Huang9School of Public Health, Global Health Institute, Fudan UniversitySchool of Public Health, Global Health Institute, Fudan UniversityProgrammatic Monitoring Department, The Global Fund to Fight AIDS, Tuberculosis and MalariaCenter for Global Health and Social Responsibility, University of MinnesotaHead of Monitoring Evaluation at National Malaria Control Program (NMCP)Research Officer at National Malaria Control Program (NMCP)Deputy Coordinator at National Malaria Control Program (NMCP)Coodinator at National Malaria Control Program (NMCP)School of Public Health and Social Sciences, Muhimbili University of Health and Allied SciencesSchool of Public Health, Global Health Institute, Fudan UniversityAbstract Background Despite the World Health Organization’s recommendations, the uptake of Intermittent Preventive Treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) in Senegal remains suboptimal, with disparities observed between urban and rural areas. More remains to be known about how malaria service readiness would affect the utilization of IPTp-SP. Methods Data were obtained from seven annual rounds of Demographic and Health Surveys (DHS) and Service Provision Assessments (SPA) in Senegal from 2012 to 2019. Using sample domain linkage to link the databases at the regional level. A malaria service readiness index was calculated to quantify the malaria service delivery capacity within the service environment where women reside. The Heckman selection model was utilized to analyze the relationship between malaria service readiness and IPTp-SP utilization. Results From 2012 to 2019, the average number of IPTp-SP doses received in Senegal was 1.66 (95% CI: 1.65–1.68), higher in urban areas [1.73 (95% CI: 1.71–1.75)] than rural areas [1.63 (95% CI: 1.62–1.65)]. Each one-point increase in malaria service readiness led to a rise of 0.251 doses in IPTp-SP. The significant interaction (Coef. = − 0.523, P < 0.001) indicated that women in rural areas received fewer doses of IPTp-SP (0.089) than in urban areas (0.612) for every unit increase in malaria service readiness. Conclusions Linking household and health facility surveys revealed significant room for improvement in malaria service readiness and IPTp-SP utilization in rural areas in Senegal. For better IPTp-SP coverage, differential strategies are required for urban and rural settings. Urban areas need to enhance malaria service readiness, while rural areas should focus on improving service readiness alongside infrastructure and community engagement to bridge the urban-rural disparities. Graphical abstracthttps://doi.org/10.1186/s40249-025-01341-5Intermittent preventive treatmentPregnancyMalaria service readinessUrban-rural disparitiesSenegal |
| spellingShingle | Yongsheng Jiang Di Liang Jinkou Zhao Shailendra Prasad Medoune Ndiop Serigne Amdy Thiam Ibrahima Diallo Doudou Sene Rose Mpembeni Jiayan Huang Bridging urban-rural disparities in malaria care during pregnancy in Senegal: evidence from household and health facility surveys Infectious Diseases of Poverty Intermittent preventive treatment Pregnancy Malaria service readiness Urban-rural disparities Senegal |
| title | Bridging urban-rural disparities in malaria care during pregnancy in Senegal: evidence from household and health facility surveys |
| title_full | Bridging urban-rural disparities in malaria care during pregnancy in Senegal: evidence from household and health facility surveys |
| title_fullStr | Bridging urban-rural disparities in malaria care during pregnancy in Senegal: evidence from household and health facility surveys |
| title_full_unstemmed | Bridging urban-rural disparities in malaria care during pregnancy in Senegal: evidence from household and health facility surveys |
| title_short | Bridging urban-rural disparities in malaria care during pregnancy in Senegal: evidence from household and health facility surveys |
| title_sort | bridging urban rural disparities in malaria care during pregnancy in senegal evidence from household and health facility surveys |
| topic | Intermittent preventive treatment Pregnancy Malaria service readiness Urban-rural disparities Senegal |
| url | https://doi.org/10.1186/s40249-025-01341-5 |
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