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Factors associated with the uptake of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine: The experiences of postpartum women attending child welfare clinics in three rural districts in the Western Region of Ghana.

Background Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is a key preventive strategy. However, optimal uptake remains inconsistent despite high antenatal care (ANC) attendance. This study assessed factors associated with IPTp-SP uptake and explored the experiences of postpartum women in rural Ghana. Methods A mixed-method study was conducted among 1,155 postpartum women attending child welfare clinics in Jomoro, Prestea-Huni Valley and Ellembelle districts of the Western Region of Ghana. Quantitative data were collected using structured questionnaires and analysed using descriptive statistics and chi-square tests. Qualitative data from in-depth interviews and focus group discussions were analysed thematically to explore womens experiences and perceptions. Results Overall, 73.5% (812/1105) of respondents received at least three doses of SP during pregnancy, in line with WHO recommendations. The most common number of doses received was three doses (31.5%, 348/1105), followed by four doses (26.4%, 292/1105), while a smaller proportion (8.1%, 90/1105) received only one dose. Knowledge of malaria in pregnancy was generally high: 92.7% (1027/1155) of respondents correctly identified its mode of transmission, while 75.1% (830/1155) and 83.5% (923/1155) were aware of the effects of malaria on pregnancy and the foetus, respectively. Uptake was not significantly associated with socio-demographic characteristics, including age, education, occupation, marital status, gravidity, and parity (p > 0.05). However, number of ANC visits was significantly associated with uptake (p = 0.006). Although not statistically significant, lower uptake was observed among peri-urban residents and uninsured women. Qualitative findings indicated that while women recognized the benefits of IPTp-SP, side effects such as nausea, dizziness, and discomfort, as well as challenges with tablet formulation and dosing negatively influenced adherence. Conclusions IPTp-SP uptake was high and largely independent of socio-demographic factors but strongly influenced by ANC attendance. Addressing experiential barriers and strengthening patient-centered counselling during ANC may further improve uptake and adherence.

Clinician knowledge and self-efficacy in snakebite management: A cross-sectional assessment in Northern Uganda

Background: Snakebite envenomation (SBE) is a major public health crisis in rural Uganda, yet it remains a neglected tropical disease. Effective management is often compromised by systemic barriers and a lack of clinician training. This study assessed clinician self-efficacy and objective knowledge regarding SBE management in Northern Uganda. Methods: A descriptive, cross-sectional study was conducted between February and July 2025 among 379 healthcare workers in Gulu, Omoro, and Pader districts. A validated questionnaire was used to collect data on socio-demographics, self-reported efficacy (scale 1-10), and objective knowledge. Knowledge scores [&ge;]70% were categorized as adequate. Multivariable logistic regression identified independent predictors of adequate knowledge, and Spearmans correlation ({rho}) assessed the relationship between knowledge and self-efficacy. Results: The participants had a mean age of 35.6 years (SD {+/-}7.3), were predominantly female (56.5%, 214/379), and most (83.6%, 317/379) practiced at Health Centre III level facilities. While 53.8% (204/379) reported prior training, 48.3% (183/379) of these had not received an update in over 10 years. Adequate knowledge was demonstrated by 51.5% (195/379) of participants. In the multivariable analysis, practicing in Omoro (adjusted odds ratio [aOR]: 0.3, 95% CI: 0.1-0.6, p < 0.001) or Pader (aOR: 0.2, 95% CI: 0.1-0.4, p < 0.001) was associated with lower odds of adequate knowledge compared to Gulu district. Prior training significantly increased the odds of adequate knowledge (aOR: 2.3, 95% CI: 1.3-4.2, p = 0.006). A moderate positive correlation was observed between self-efficacy and objective knowledge (Spearmans {rho} = 0.33, p < 0.0001). Conclusion: Approximately half of the frontline healthcare workers in Northern Uganda lack adequate knowledge on SBE management, with significant geographic differences and outdated training. The gap between clinician self-efficacy and objective knowledge poses a risk to patient safety. Regular, mandatory refresher training and targeted educational outreach to remote districts are required to reduce SBE-related morbidity and mortality.