Knowledge of Malaria Transmission and Prevention among Pregnant Women Attending Antenatal Care at Atebubu Government Hospital, Bono East Region, Ghana: A Cross-sectional Study

Abstract

Background: Malaria in pregnancy remains a major public health challenge in Ghana, contributing to maternal anaemia, low birth weight, and adverse neonatal outcomes. Preventive interventions such as insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) are routinely delivered through antenatal care (ANC) services. However, their effectiveness largely depends on pregnant women’s knowledge and adoption of recommended preventive practices. Objective: To assess knowledge of malaria transmission and prevention and its relationship with preventive practices among pregnant women attending ANC at Atebubu Government Hospital, Bono East Region, Ghana. Methods: A descriptive cross-sectional study was conducted among 300 pregnant women attending ANC at Atebubu Government Hospital between October and December 2025. Participants were recruited using a consecutive sampling technique. Data were collected using a structured questionnaire adapted from validated malaria survey tools. Descriptive statistics were used to summarise knowledge and preventive practices, and chi-square analysis was used to examine associations between variables at a 5% level of significance. Results: Knowledge of malaria transmission and prevention was moderate, with 52.0% of respondents demonstrating good knowledge. Most respondents correctly identified mosquito bites as the primary mode of malaria transmission and were aware of key preventive measures such as ITN use and IPTp-SP. However, misconceptions regarding asymptomatic malaria, medication safety, and pregnancy-related complications persisted. Preventive practices were generally satisfactory, although gaps in the consistent use of recommended interventions were observed. A statistically significant association was found between knowledge and preventive practices (χ² = 24.6, df = 1, p < 0.001), and women with good knowledge were more likely to demonstrate good preventive practices than those with poor knowledge. Conclusion: Although pregnant women attending ANC at Atebubu Government Hospital demonstrated moderate knowledge of malaria prevention, important knowledge gaps remain. The significant association between knowledge and preventive practices highlights the importance of strengthening ANC-based health education and behaviour change interventions to improve the uptake of malaria prevention measures during pregnancy.