Factors associated with the optimal 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 optimal IPTp-SP uptake and explored the experiences of postpartum women in rural Ghana. Methods: A convergent parallel 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 women’s experiences and perceptions. Results: Among the 1,155 women enrolled, 812 (70.3%) took three or more doses of IPTp-SP (IPTp3-SP). Knowledge of malaria in pregnancy was high, with 92.7% correctly identifying its mode of transmission and 91.7% identifying ways of preventing malaria during pregnancy. Factors independently associated with IPTp3-SP included age 10–19 years compared with 20–29 years (aOR 2.17, 95% CI 1.21–3.88), gravidity of three compared with one (aOR 2.67, 95% CI: 1.58–4.50), and gravidity of four compared with one (aOR 1.83, 95% CI: 1.02–3.28). Lower odds were observed among uninsured women (aOR 0.36, 95% CI: 0.20–0.64), single women (aOR 0.64, 95% CI: 0.42–0.97), and cohabiting women (aOR 0.52, 95% CI: 0.34–0.79). ANC attendance showed a strong association with IPTp3-SP: women attending