Political Economy Analysis of Intermittent Preventive Treatment of Malaria in Pregnancy Using Sulfadoxine-Pyrimethamine in the Volta Region of Ghana

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Abstract Introduction Over years, stakeholder control over the implementation process of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) has been underestimated. As a result, stakeholder influence has not been effectively organized to achieve the global target of 80% or more for the uptake of 3 plus doses of IPTp-SP. This study aimed to explore the influence of stakeholders on the implementation of IPTp-SP policy. Methods In-depth interviews were conducted with key stakeholders purposively identified in the region. Data was transcribed, coded and themes were developed from the responses using Atlas ti 8. Results The primary actors identified in the implementation of IPTp-SP policy include; interest groups, bureaucracies, financial decision-makers, political leaders, policy beneficiaries, and donors. It was discovered that activities such as the formation of mother support groups help to educate women in their communities to use IPTp-SP policy and soliciting timely feedback from policy recipients positively influences the uptake of the IPTp-SP policy. Whilst stakeholder activities like the failure of the ministry of health to provide practical proof on the possible consequences of IPTp-SP policy, the command-and-control tactics of controlling from the national level, the unclear budget delivery, and spending, and uncoordinated donor activities negatively affect the IPTp-SP policy implementation. Conclusions For a successful IPTp-SP policy implementation, implementers must understand and address all rivalry, resistance, and collaboration among the various actors controlling the IPTp-SP policy implementation.

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