Spatial and Temporal Trends in the Use of Malaria Prevention Measures among Pregnant Women in Guinea (2005–2021): Insights from Generalized Additive Models
Abstract:
Malaria during pregnancy continues to pose a major public health challenge in Guinea, contributing significantly to maternal and neonatal morbidity and mortality. This study examines trends and key determinants of malaria prevention among pregnant women in Guinea from 2005 to 2021, using data from four nationally representative Demographic and Health Surveys. We assessed insecticide-treated net use and intermittent preventive treatment uptake during pregnancy using descriptive statistics, spatial mapping, and generalized additive models. Results show moderate improvement in insecticide-treated net use over time, while intermittent preventive treatment coverage remained consistently low. Higher uptake of both interventions was observed among women in urban areas, from wealthier households, and those with higher levels of education. In contrast, poorer, less educated rural women, particularly in regions such as Labé, Mamou, and parts of Kankan, were particularly underserved. Other predictors included ethnicity, media access, and antenatal care attendance. Spatial analyses revealed significant geographic disparities, with national averages masking subregional inequalities. These findings highlight the persistent structural barriers that hinder equitable coverage of malaria prevention during pregnancy. Addressing these gaps requires equity-focused, geographically specific strategies that integrate social, economic, and health considerations. The study provides critical evidence to inform targeted policies and programs aimed at reducing disparities and improving maternal health in malaria-endemic areas.
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