Systematic assessment of factors affecting the delivery, access and use of interventions to control malaria in pregnancy in sub-Saharan Africa - Chapter 9: Supplementary appendix

(1)

UvA-DARE is a service provided by the library of the University of Amsterdam (https://dare.uva.nl)

Systematic assessment of factors affecting the delivery, access and use of

interventions to control malaria in pregnancy in sub-Saharan Africa

Hill, J.A.

Publication date

2014

Document Version

Final published version

Link to publication

Citation for published version (APA):

Hill, J. A. (2014). Systematic assessment of factors affecting the delivery, access and use of

interventions to control malaria in pregnancy in sub-Saharan Africa. Dutch University Press.

General rights

It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons).

Disclaimer/Complaints regulations

If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible.

(2)

Chapter 9:

Supplementary Appendix

(3)

Table S1. Search terms and databases used in the review. Search terms for Pregnant Women

Global Health Search MiP Library Search* INRUD* pregnant wom* AND ---- pregnant wom* AND malaria AND ---- malaria

treat* OR treatment seeking behav* OR health seeking behav* OR care seeking behav* OR treatment seeking practice* OR health seeking practice* OR care seeking practice* OR treatment seeking decision*

AND

treat* OR treatment seeking behav* OR health seeking behav* OR care seeking behav* OR treatment seeking practice* OR health seeking practice* OR care seeking practice* OR treatment seeking decision* AND ----determinant* OR factor* OR knowledge OR attitude* OR practice* OR compliance OR adherence OR frequenc* OR symptom* OR recogn* OR perception determinant* OR factor* OR knowledge OR attitude* OR practice* OR compliance OR adherence OR frequenc* OR symptom* OR recogn* OR perception

----Search terms for Health Provider

Global Health Search MiP Library Search* INRUD pregnan* OR pregnant wom*

AND

---- pregnant wom*

AND provider* OR ANC service* OR

antenatal service* OR ANC OR health provider OR health work* OR health servic* provider OR drug shop vendor OR community health worker OR licensed chemical seller OR patent medicine seller OR ADDO OR community drug dispenser OR formal service OR informal service

AND

provider* OR ANC service* OR antenatal service* OR ANC OR health provider OR health work* OR health servic* provider OR drug shop vendor OR community health worker AND

malaria

malaria AND

----

----case management OR control OR management OR treat* OR diagno* OR prescrib* OR practice* OR chloroquine OR CQ OR quinine OR ACT OR artemisinin-based combination therapy OR safe* OR community case management OR refer* OR practice

AND

case management OR control OR management OR treat* OR diagno* OR prescrib* OR practice* OR safe* OR community case management OR refer* OR practice AND ----knowledge OR compliance OR adherence OR proportion* OR frequenc* OR symptom* OR refer* knowledge OR compliance OR adherence OR proportion* OR frequenc* OR symptom* OR refer*

1* All material in the MiP Library contain the words malaria and pregnant women 2* Terms kept very broad for INRUD search

(4)

Ta bl e S2 . C he ckli st fo r quali ty of r epor ti n g: Quanti tat iv e Studi es . We appraise d the quality of re po rting o f e ach study using a che cklist o f criteria based o n m e th o d s describe d in a prev io us re view [1]. Quantitati ve studies wer e assessed f o r repo rting o f 10 cri teria, as f o llows: s tudy co n tex

t, sampling strategy, use

o f random izati o n , m etho d o lo gy, sys

tematic data anal

ys is, m u lti variate anal ysis, the m ini m izatio n of recall, s o cial d e sirability an d m e asur em ent bias, and whether the findings w e re discussed in ref erenc e t o p o licy , pro gra mm ing o r furt her rese arch [2 ,3]. Cri teri a SC O R E (n /10) A u thor/Y e a r Descri p ti o n of C ont e x t Pa rt ic ipa n ts a nd Sa mp li ng de s c ribe d R a ndom iza -tion us e d M e th ods d escri b ed S y stem ati c Data An a lys is d escri b ed M u lti var iate an al y si s us e d Recal l b ias min imis e d Soc ia l de sir a bi lit y b ias min imis e d M easu rem e n t bia s min imis e d Find ings d iscu ssed Ad a m , 2 0 0 8 [4 ] 5 E nat o, 2009 [5 ] 7 Ghout h, 2013 [6 ] 6 Harri s on, 2012 [7] 5 Henry. 2012 [ 8 ] 9 K al ilani -P hi ri , 2011 [9] 8 K a m uhabw a, 2011[ 10] 4 K arunam oor thi , 2010 [1 1 ] 6 K w ans a-B ent u m , 2011 [1 2 ] 8 Luz, 2013 A [13] 7 M ai ga, 2010 [14] 4 M ani rak iza, 2011 [ 15 ] 8 M bac hu, 2012 [16 ] 9 M bonye, 2010 [ 17] 4 M bonye, 2013 [18] 6 M inyal iw a, 2012 [ 19] 4 Obi e c h e, 2013 [2 0 ] 7 Ok ont a , 2011 [21] 8 Ok oro, 2012 [2 2] 6 O m o-A ghoj a, 2008 [ 23 ] 8 Onw u je k w e, 2012 [2 4] 8 Onw uj ek w e, 2013 [ 25] 5 P S I Ca m bodi a , 2007 [2 6 ] 6 S a m -W obo, 2008 [ 2 7] 5 S angare, 2011 [ 28] 9 Um ar , 2011 [29] 5 W yli e , 2010 [30] 5 Descri p ti o n o f categ o ries : in d icates i t w as rep o rted i n th e art icl e 315

(5)

Descri p ti o n o f co n text A u th ors report an adequat e desc ri pt io n of s e tti ng (urban/ rural ), ti m e of s tudy and l o c a tion Pa rt ic ipa n ts a n d s a m p ling de s c ribe d A u th ors report s a m p lin g m e thods , det ai ls of part ic ipants and rando m izat ion i s di s c u ss e d R a ndom iza tion us e d A u th ors report u s e of rando m izat io n i n s a m p ling t e c hni que M eth o d s d escri b ed A u thors us e appropri a te m e thods to addres s ai m s o f s tudy, provi de d e ta iled res ear c h proc edure s , ex pres s ex pert is e a m ongst th e re se a rc h te a m to c onduc t m e thods, or report t rai ni n g of fa ci lit a to rs S y stem ati c d ata an al y si s d escrib ed A ut h ors provi d e a det ai led proc ed ure of anal ys is , w ith j u s tif ic at ion f o r t he m e thod o f anal ysi s Mult iv a ria te a n a ly s is us e d A u th ors report u s e of m u ltiv ari a te anal ys is t o c ont rol f o r c onf oundi ng Recal l b ias m in im ised A ut h ors report u s ing m e th ods t o r educ e rec al l bi a s (e. g . u s e o f ho s pi tal re c ords e tc. ra ther t han m e m or y) S o c ial d e si ra b ili ty b ia s m in im ise d A ut h ors report u s e of m e thods t o reduc e s o c ial desirabilit y (e .g . st ock c h ecks , c h e c k HCF re c o rds, c h ec k st orage of m e di c ine s , ch e c k fo r ITN ) M e asu rem en t b ias mi n imi sed A u thors report on the rol e o f re s e a rc her, th e rel a tion s h ip o f re s earc h er t o part ic ipants/ c on tex t, adequate t rai ni ng o f s ta ff, u s e of s tandardi zed res e arc h tool s, and the u s e o f s tandardi zed m e a s ure m ents Find ings dis c us s e d A u th ors report t h e f ind ings /re s ul ts in t e rm s o f t hei r i m pact on fu rt her r e s earc h , program m in g and pol ic y 316

(6)

References

1. Hill J, Hoyt J, van Eijk AM, D'Mello-Guyett L, Ter Kuile FO, et al. (2013) Factors affecting the delivery, access, and use of interventions to prevent malaria in pregnancy in sub-Saharan Africa: a systematic review and meta-analysis. PLoS Med 10: e1001488.

2. Sanderson S, Tatt LD, Higgins JPT (2007) Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography. International Journal of Epidemiology 36: 666-676.

3. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, et al. (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Bulletin of the World Health Organization 85: 867-872.

4. Adam I, Omer el sir M, Salih A, Khamis A, Malik EM (2008) Perceptions of the causes of malaria and its complications, treatment and prevention among midwives and pregnant women of Eastern Sudan. Journal of Public Health: 129-132.

5. Enato E. F., Mens P. F., Okhamafe A. O., Okpere E. E., Pogoson E., et al. (2009) Plasmodium falciparum malaria in pregnancy: prevalence of peripheral parasitaemia, anaemia and malaria care-seeking behaviour among pregnant women attending two antenatal clinics in Edo State, Nigeria. Journal of Obstetrics and Gynaecology 29: 301-306.

6. Bin Ghouth A.S. (2013) Availability and prescription practice of anti-malaria drugs in the private health sector in Yemen. Journal of Infection in Developing Countries 7: 404-412.

7. Harrison N, Olufunlayo T, Agomo C (2012) Utilization of the current national antimalarial treatment guidleines among doctors in army hospitals in Lagos, Nigeria. Open Journal of Preventive Medicine 2: 390-393.

8. Henry O J., Lagoro K D., Orach C G. (2012) Prevalence of malaria and treatment seeking behaviours among pregnant women in postconflict internally displaced persons' camps in Gulu District. ISRN Public Health 2012: 164935. doi:10.5402/2012/164935.

9. Kalilani-Phiri LV., Lungu D., Coghlan R. (2011) Knowledge and malaria treatment practices using artemisinin combination therapy (ACT) in Malawi: survey of health professionals. Malaria Journal 10: 279.

10. Kamuhabwa AR, Mnyusiwalla F (2011) Rational dispensing and use of artemether-lumefantrine during pregnancy in Dar es Salaam, Tanzania. Tanzania Journal of Health Research 13.

11. Karunamoorthi K, Deboch B, Tafere Y (2010) Knowledge and practice concerning malaria, insecticide-treated net (ITN) utilization and antimalarial treatment among pregnant women attending specialist antenatal clinics. Journal of Public Health 18: 559-566.

12. Kwansa-Bentum B, Ayi I, Suzuki T, Otchere J, Kumagai T, et al. (2011) Administrative practices of health professionals and use of artesunate-amodiaquine by community members for treating

uncomplicated malaria in southern Ghana: implications for artemisinin-based combination therapy deployment. Tropical Medicine and International Health 16: 1215-1224.

13. Luz TCB, Miranda ES, Freitas LF, Osorio-de-Castro CGS (2013 A) Prescriptions for uncomplicated malaria treatment among pregnant women in the Brazilian Amazon: evidences from the Mafalda Project. Revista Brasileira de Epidemiologia, 16: 409 - 419 PMID PM: 24142012.

14. Maiga AS, Diakite M, Diaware A, Sango HA, Coulibaly CO (2010) Pharmacovigilance and impact of intermittent preventive treatment with sulfadoxine-pyrimethamine for pregnant women in Selingue in Mali. Mali Medical 25: 41-48.

15. Manirakiza A, Soula G, Laganier R, Klement E, Djalle D, et al. (2011) Pattern of the antimalarials

prescription during pregnancy in Bangui, Central African Republic. Malaria Research and Treatment 2011: 414510.

16. Mbachu CO, Onwujekwe O. E., Uzochukwu B. S., Uchegbu E., Oranuba J., et al. (2012) Examining equity in access to long-lasting insecticide nets and artemisinin-based combination therapy in Anambra state, Nigeria. BMC Public Health 12: 315.

(7)

antimalarial drug use in pregnancy in central Uganda: results from a community trial. International Journal of Adolescent Medicine and Health 22: 257-262.

18. Mbonye AK, Birungi J, Yanow S, Magnussen P (2013) Prescription patterns and drug use among pregnant women with febrile Illnesses in Uganda: a survey in out-patient clinics. BMC Infectious Diseases 13: 237 PMID 23702003.

19. Minyaliwa C, Bandawe C, Mwale RJ (2012) How much do Blantyre dispensers in hospital and

community pharmacies know about the new malaria treatment guidelines? Malawi Medical Journal 24: 1-4.

20. Obieche AO, Enato EF, Ande AB (2013) Patterns of treatment of reported malaria cases during pregnancy in a Nigerian hospital. Scandinavian Journal of Infectious Diseases 45:849-854. PMID 23968224.

21. Okonta PI (2011) How many physicians prescribe quinine for the treatment of malaria in the first trimester of pregnancy? . Ebonyi Medical Journal 10: 105-111.

22. Okoro RN, Nwambu JO (2012) Evaluation of physicians' prescribing patterns of antimalarial drugs during pregnancy at the obstetrics and gynaecology department of a teaching hospital in Maduguri, Borno State, Nigeria. International Journal of Pharmacy and BioMedical Sciences 3: 39-46.

23. Omo-Aghoja LO, Aghoja CO, Oghagbon K, Omo-Aghoja VW, Esume C (2008) Prevention and treatment of malaria in pregnancy in Nigeria: obstetrician's knowledge of guidelines and policy changes-a call for action. Journal of Chinese Clinical Medicine 3: 114-120.

24. Onwujekwe OC, Soremekun RO, Uzochukwu B, Shu E, Onwujekwe O (2012) Patterns of case

management and chemoprevention for malaria-in-pregnancy by public and private sector health providers in Enugu state, Nigeria. BMC Research Notes 5: 211.

25. Onwujekwe O, Onwujekwe OO, Soremekun R (2013) Chemotherapy and chemoprophylaxis of malaria in pregnancy in private and public facilities: perceptions and use by pregnant women in Enugu State, Nigeria. Gender and Behaviour 11: 5688 - 5697.

26. PSI Cambodia (2007) Cambodia 2007: TRaC Study exploring the determinants of malaria health care provision among private providers in malaria endemic areas. First Round. Washington, District of Columbia

27. Sam-Wobo SO, Akinboroye T, Anosike JC, Adewale B (2008) Knowledge and practices on malaria treatment measures among pregnant women in Abeokuta, Nigeria. Tanzania Journal of Health Research 10: 226-231.

28. Sangare LR, Weiss NS, Brentlinger PE, Richardson BA, Staedke SG, et al. (2011) Patterns of anti-malarial drug treatment among pregnant women in Uganda. Malaria Journal 10: 152.

29. Umar MT, Chika A, Jimoh AO (2011) Compliance of primary health care providers to recommendation of artemesinin-based combination therapy in the treatment of uncomplicated malaria in selected primary health care centres in Sokoto, north western Nigeria. International Journal of Tropical Medicine 6: 70-72.

30. Wylie BJ, Hashmi AH, Singh N, Singh MP, Tuchman J, et al. (2010) Availability and utilization of malaria prevention strategies in pregnancy in eastern India. BMC Public Health 10: 557.

(8)

Ta bl e S3 . C he ckli st fo r quali ty of r epor ti n g: Qual itative Studi es . W e apprais e d t h e qualit y of re po rt ing o f e ach st

udy using a che

cklist o f criteria b ased o n meth o d s des cribed in a prev io us rev ie w [1 ]. Qualitative s tudies were as sessed f o r th e ex ten t to wh ich th e a u th ors d e sc rib e d 8 crit eria : stu d y con tex t, sa mp lin g strateg y, meth od ol og y, sat u ration of d ata, sys te m ati c data analy sis, th e refl exi vity of the research er, the reliabilit y a nd v alidity o f findings, and the rel ev anc e o f findings t o po licy , pro gra mm ing o r fur ther res earc h [2 ,3 ]. Cri teri a SC O R E (n /8 ) A u th o r/Y ear D e s c ript ion of Co n text Pa rt ic ipa nt s a nd Sa mp li ng M e th ods d escri b ed S atu rati o n me nt io ne d S y stem ati c Data A n al y si s d escri b ed R e lia b ility a n d v a lidit y d iscu ssed Refl exi vi ty o f research er doc ume n te d Find ings d iscu ssed E nat o, 2012 [4 ] 4 Lanui al a, 2010 [ 5 ] 5 P el l, 2013 [6 ] 8 Sm ith-P a in ta in , 2 010 [ 7 ] 7 Descri p ti o n o f categ o ries : in d icates i t w as rep o rted i n th e art icl e Descri p ti o n o f co n text A u thors report an adequat e desc ri pt ion of s e tti ng (urban/ rural ), ti m e of s tudy and l o c a tion P a rti c ip a n ts an d samp li n g d e sc ri b e d A u thors report s a m p lin g m e thods , det ai ls of part ic ipants and rando m izat ion i s di s c u ss e d M e th o d s d escr ib e d A u thors us e appropri a te m e thods to addres s ai m s o f s tudy, provi de d e ta iled res ear c h proc edure s , ex pres s e xp ert is e a m ongst th e re se a rc h te a m to c onduc t m e th ods, or report t rai ni n g of fa ci lit a to rs Sa tu ra tion me nt io ne d A u thors di sc u s s t h e s a tu rat ion o f d a ta f ro m u s ing res ear c h m e thods c hos en S y stem ati c d ata an al y si s d escrib ed A u thors provi de a det ai le d proc ed ure of anal ys is , w ith j u s tif ic at io n f o r t h e m e thod o f anal ysi s Rel iab il ity an d val id ity d iscu ssed A ut hors c an ex pres s rel iabi lit y and report st eps t a k en to reduc e m ea s ure m ent, s oc ia l de s irabi lit y and m eas ure m ent b ias e s (e .g . t ri angul at ion of m e thods ), and c an de s c ri be val ida tion of t ran s c ri p ts/ dat a Refl exi vi ty o f research er d o cu men ted A u thors report on the e ffe c t of the res earc her, rol e of re s earc her and t he rel a tions hi p of res earc her to p a rt ic ip ants/ c o n tex t F in d in g s d isc u ssed A u thors report t h e f ind in gs /re s ul ts in t e rm s o f t hei r i m pact on fu rt her r e s earc h , program m ing and pol ic y 319

(9)

2. Barbour RS (2001) Checklists for improving rigour in qualitative research: a case of the tail wagging the dog? BMJ 322: 1115-1117.

3. Mays N, Pope C (2000) Qualitative research in health care. Assessing quality in qualitative research. BMJ 320: 50-52.

4. Enato EFO, Erihri RE (2012) Knowledge, perception and management of malaria in pregnancy by traditional birth attendants in Benin City. Journal of Pharmaceutical and Allied Sciences 8: 1292-1297.

5. Launiala A, Honkasalo ML (2010) Malaria, danger, and risk perceptions among the Yao in rural Malawi. Medical Anthropology Quarterly Q24: 399-420.

6. Pell C, Menaca A, Afrah NA, Manda-Taylor L, Chatio S, et al. (2013) Prevention and management of malaria during pregnancy: findings from a comparative qualitative study in Ghana, Kenya and Malawi. Malaria Journal 12: 427. PMID PM:24257105.

7. Smith Paintain LA, Jones C, Adjei RO, Antwi GD, Afrah NA, et al. (2010) Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: user acceptability. Malaria Journal 9: 18.

(10)

Ta bl e S4 . C he ckli st fo r quali ty of r epor ti n g: Mi xed Me thods . We appraised th e quality of repo rting o f each study u sing a chec klist o f cri teria b ased o n m etho d s des cribe d in a prev io us r e view [ 1 ]. Mixed me th od s s tu d ies w ere asses sed fo r the r e po rting o f 1 1 crit eria: study co nt ext , sam p ling strate gy , me th od ol og y, ju sti fic ati o n of mi xed me th od s, sys te m ati c dat a analys is, m u lti variate anal ysis, m inim ization o f bias, the inte gra tio n o f qualitativ e and quantitati ve findings and the e xte nt t o w h ich the findings we re discusse d in re fe re nc e t o po licy, pr o gra m m ing o r furt her research [2 -4 ]. Cri teri a SC O R E (n /11) A u thor/Y e a r Descri p ti o n of C o nt e x t Pa rt ic ipa nt s a n d Sa mp li ng d escri b ed M e th ods d escr ib ed Ju sti fi cati o n o f mi xed me thods S y stem ati c Data An a lys is d escri b ed Mult iv a ria te an al y si s us e d Min im iza tion of bia s d iscu ssed Int e gra tio n of QU A N /Q U A L co m p o n en ts Find ings d iscu ssed QU A N QU A L QU A N QU A L K ini ngu, 2013 [ 5 ] 10 Luz, 2013 B [ 6] 9 S a bi n, 2010 [ 7 ] 10 S m ith-P ai nt a in , 2011 [8 ] 10 S tangel and, 2011 [ 9 ] 9 T aw fik , 2006 [10] 9 Descri p ti o n o f categ o ries : in d icates i t w as rep o rted i n th e art icl e Descri p ti o n o f co n text A u thors report an adequat e desc ri pt ion of s e tti ng (urban/ rural ), ti m e of s tudy and l o c a tion Pa rt ic ipa nt s a n d s a m p ling de s c ribe d A u th ors report s a m p lin g m e thods , ju s tif y u s e of s a m p lin g m e thod s an d provi de det ai ls of part ic ipants Me th o d s d e s c rib e d A u th ors us e appropri a te m e thods to addres s ai m s o f s tudy, provi de d e ta iled res e ar c h proc edure s , ex pres s ex pert is e a m ongst th e re se a rc h te a m to c onduc t m e th ods, or report trai n ing of f a ci lit a tors Ju sti fic ati o n o f mi xed m e th o d s A u thors di sc u s s and j u s tif y the pur pos e, pri o ri ty and s e quenc e o f m e thods us ed . S y stem ati c d ata an al y si s d escrib ed A ut hors provi d e a det ai led proc ed ure of anal ys is , w ith j u s tif ic at ion f o r t he m e thod o f anal ysi s Mult iv a ria te a n a ly s is us e d A u thors report u s e of m u ltiv ari a te anal ys is t o c ont rol f o r c o nf oundi ng Min im iz a tion of bia s dis c us s e d A u thors report s tep s ta k e n t o redu c e m e a s ure m ent, s o c ial de s irabi lity, rec a ll, and m eas ure m en t bi a s e s. Int e g ra tio n of QU A N /QU A L co m p o n en ts A u th ors report t h e i n tegrati on of Q U A N /Q UA L m e thod s and res u lts Find ings dis c us s e d A u thors report t h e f ind ings /re s ul ts in t e rm s o f t h ei r i m pact on fu rt her r e s earc h , program m ing and pol ic y 321

(11)

2. O'Cathain A, Murphy E, Nicholl J (2008) The quality of mixed methods studies in health services research. Journal of Health Services Research & Policy 13: 92-98.

3. Pluye P, Gagnon MP, Griffiths F, Johnson-Lafleur J (2009) A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in Mixed Studies Reviews. International Journal Of Nursing Studies 46: 529-546. 4. Sale JEM, Brazil K (2004) A strategy to identify critical appraisal criteria for primary mixed-method

studies. Quality & Quantity 38: 351-365.

5. Kiningu D.K. (2013) Factors influencing the use of evidence based guidelines in the management of malaria in pregnancy among health workers at Garissa provincial hospital, Kenya. [Master’s thesis]. Nairobi: School of Public Health, University of Nairobi. Available:

http://erepository.uonbi.ac.ke:8080/xmlui/bitstream/handle/11295/59598/Factors%20Influencing %20The%20Use%20Of%20Evidence%20Based%20Guidelines%20in%20the%20Management%20of %20Malaria%20in%20Pregnancy%20Among%20Health%20Workers%20at%20Garissa%20Provincial %20Hospital%20Kenya.pdf?sequence=3. Accessed 7 July 2014

6. Luz TC, Suarez-Mutis C, Miranda S, Moritz F, Freitas F, et al. (2013 B) Uncomplicated malaria among pregnant women in the Brazilian Amazon: Local barriers to prompt and effective case management. Acta Tropica 125: 137-142.

7. Sabin LL, Rizal A, Brooks MI, Singh MP, Tuchman J, et al. (2010) Attitudes, knowledge, and practices regarding malaria prevention and treatment among pregnant women in Eastern India. American Journal of Tropical Medicine and Hygiene 82: 1010-1016.

8. Smith Paintain L, Antwi GD, Jones C, Amoako E, Adjei RO, et al. (2011) Intermittent Screening and Treatment versus Intermittent Preventive Treatment of Malaria in Pregnancy: Provider Knowledge and Acceptability. Plos One 6: e24035.

9. Stangeland T, Alele PE, Katuura E, Lye KA (2011) Plants used to treat malaria in Nyakayojo sub-county, western Uganda. Journal of Ethnopharmacology 137: 154-166.

10. Tawfik L (2006) Mosquitoes, Malaria and Malarine: A Qualitative Study on Malaria Drug Use in Cambodia. Arlington, Virginia, USA: U. S. Agency for International Development.

(12)

Table S5. Sub-group analysis for source of treatment among pregnant women. N* Pooled effect

estimate (95% CI)

N Pooled effect estimate (95% CI)

p-value†

Type of question PW with fever If PW would have fever

Doctor 3 0.84 (0.65-0.94) 1 0.82 (0.75-0.87) 0.7

Health facility or ANC 4 0.60 (0.33-0.82) 2 0.46 (0.01-0.98) 0.8 Self-Medication 5 0.14 (0.06-0.32) 2 0.08 (0.06-0.12) 0.3 Traditional healer/herbs 5 0.03 (0.01-0.17) 2 0.24 (0.01-0.93) 0.3

Site of enrolment PW Antenatal clinic Community

Doctor 3 0.84 (0.65-0.94) 1 0.82 (0.75-0.87) 0.7

Country of study Nigeria Not Nigeria

Doctor 2 0.90 (0.75-0.96) 2 0.74 (0.53-0.88) 0.1

Location of residence Rural Urban

Doctor 2 0.74 (0.53-0.88) 2 0.90 (0.75-0.96) 0.1

Health facility or ANC 4 0.38 (0.14-0.70) 2 0.84 (0.71-0.91) 0.006 Self-Medication 3 0.20 (0.06-0.51) 4 0.08 (0.04-0.19) 0.2 Traditional healer/herbs 4 0.21 (0.06-0.52) 3 0.02 (0.00-0.07) 0.008 “Private clinic” and “Retail/pharmacy” not examined; only 1 and 3 studies in total, respectively *N: indicates number of studies in subgroup

†Sub-group analysis was conducted with the program “Comprehensive Meta-Analysis”

(13)

Table S6. Sub-group analysis for adherence to treatment policy among health care providers. Factor N* Pooled effect estimate (95% CI) p-value† Trimester

First trimester 9 0.45 (0.19-0.75) 0.067

Other trimesters 5 0.28 (0.14-0.47) Trimester not specified 7 0.72 (0.39-0.91)

First trimester 9 0.28 (0.14-0.47) 0.021

Other trimesters 5 0.72 (0.39-0.91) Level of prescriber

Doctors only 3 0.11 (0.04-0.23) <0.001

Other staff or mixed cadres 18 0.52 (0.35-0.67) Method of study Self-administered questionnaires 6 0.14 (0.07-0.28) 0.001 Interviews 7 0.50 (0.27-0.73) Record reviews 8 0.66 (0.39-0.86) Country of study Nigeria 10 0.25 (0.12-0.46) 0.018 Not Nigeria 11 0.58 (0.40-0.75) *N: indicates number of studies in subgroup

†Sub-group analysis was conducted with the program “Comprehensive Meta-Analysis”