{
  "abstract": "Introduction: Intermittent preventive treatment of malaria in pregnancy with sulfadoxine -pyrimethamine (IPTp-SP) is a World Health Organization (WHO) recommended intervention delivered primarily through antenatal care (ANC) platforms. Nigeria continues to report a persistent gap between ANC attendance and IPTp-SP completion, suggesting missed opportunities at the point of service. This baseline assessment quantified implementation gaps in IPTp-SP delivery and explored socioeconomic differentials that may lead to deficiencies in effective coverage. Methods: A cross-sectional baseline survey was conducted among 250 pregnant women (18-49 years) attending ANC in three secondary facilities across Osun State (State Specialist Hospital Asubiaro; State Hospital Ede; State Hospital Ilesa). Eligible women had received at least one SP dose in the current pregnancy. Data were collected using an interviewer-administered questionnaire configured in KoBoCollect. Key implementation outcomes included SP availability, directly observed therapy (DOT), and provider counselling. Knowledge was assessed using an 11-item composite score and classified as good knowledge at ≥7/11. Socioeconomic position was proxied by self-reported monthly income categories and autonomy indicators. Descriptive statistics and multivariable logistic regression were used to identify correlates of DOT. Results: The mean age of the participants was 29.7±5.1 years; mean booking gestational age was 18.5±6.8 weeks; and mean ANC visits were 3.6±2.0. While SP was reported as “always available” by 71.6% and available on the day of visit by 74.0%, DOT was reported by only 24.0% and provider explanation by 7.6%. Facility-level variation was substantial: DOT ranged from 10.2% to 65.2%. Socioeconomic constraints were evident: only 47.6% could afford SP and 36.8% met criteria for high autonomy. Conclusion: Findings indicate major implementation failures, particularly in DOT and counselling, despite a moderate level of reported SP availability. These gaps are likely to sustain inequities and limit effective coverage. Interventions should prioritise standardised DOT workflows, supervision and job aids, commodity/security mechanisms, and equity-oriented support for women facing cost and autonomy constraints.",
  "abstract_shown": true,
  "affiliations": [
    "African Field Epidemiology Network, Abuja, Nigeria; Department of Public Health, Adeleke University, Ede, Osun State, Nigeria",
    "Department of Public Health, Adeleke University, Ede, Osun State, Nigeria",
    "UNICEF Nigeria",
    "Malaria Unit, Department of Public Health, Osun State Ministry of Health, Nigeria",
    "Department of Public Health, University of Ilorin, Ilorin, Nigeria"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Tosin Orhorhamreru",
      "orcid": "0000-0002-8799-8955"
    },
    {
      "affs": [
        1
      ],
      "name": "Opeyemi Oladunni"
    },
    {
      "affs": [
        1
      ],
      "name": "Adefunke Busola Ogunleye"
    },
    {
      "affs": [
        2
      ],
      "name": "Moronke Rachael Orhorhamreru"
    },
    {
      "affs": [
        3
      ],
      "name": "Braimah Rasheed Oyeyemi"
    },
    {
      "affs": [
        3
      ],
      "name": "Olufemi Oroge"
    },
    {
      "affs": [
        4
      ],
      "name": "Adekunle Ganiyu Salawudeen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/205z452hnva5j.bib",
  "cited_by": 0,
  "doi": "10.37432/jieph-d-26-00098",
  "fulltext_url": "https://afenet-journal.org/10-37432-jieph-d-26-00098/",
  "id": "205z452hnva5j",
  "issns": [
    "2664-2824"
  ],
  "landing_url": "https://doi.org/10.37432/jieph-d-26-00098",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R"
    ],
    [
      "openalex",
      "2739|Malaria Research and Control"
    ]
  ],
  "openalex": "W7224502757",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-01",
  "publisher": "African Field Epidemiology Network",
  "ris": "https://research.draconitic.com/paper/205z452hnva5j.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T14:21:54Z",
      "native_id": "0443590fe4724f1a9cae997edcc88086",
      "source": "doaj",
      "url": "https://doi.org/10.37432/jieph-d-26-00098"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Malaria Research and Control",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Missed opportunities in IPTp-SP delivery during antenatal care in Osun State, Nigeria",
  "title_text": "Missed opportunities in IPTp-SP delivery during antenatal care in Osun State, Nigeria",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:21:54Z",
  "url": "https://research.draconitic.com/paper/205z452hnva5j",
  "venue": "Journal of Interventional Epidemiology and Public Health",
  "versions": []
}