Malaria during pregnancy is a serious health risk for pregnant women; it is associated with maternal and infant morbidity and mortality. In Uganda, Intermittent Preventive Treatment (IPT) for prevention of Malaria in pregnancy, coverage one and two are still low standing at 61%, 38% respectively.

To identify client-related, health worker-related and health-related factors affecting adherence to IPT.

A descriptive cross-sectional study involving 222 pregnant women and 15 health workers was undertaken in Kampala City Council (KCC) health centre IV (Kawempe, Naguru and Kiruddu), Data was collected using interview guided and self-administered questionnaires and checklist.

Only 21% of pregnant women were told about the use of drugs to prevent malaria; 31.5% knew the recommended drug used in prevention of malaria in pregnancy; while 4.5% knew the fansidar recommended doses taken. Over 95% of pregnant women reported no health education was given to them concerning IPT. Surprisingly only 34.4% took fansidar under observation by a health worker. Guidelines on malaria in pregnancy were not referred to and only 1.6% of health workers were trained in the last six months. Generally all the three heath units lacked cups, kettles, posters on prevention of malaria in pregnancy and IPT. Awareness and use of IPT among pregnant women in KCC health units was very low. Health workers knew the importance of IPT but practice as directly observed therapy was poor. KCC should strengthen campaigns for IPT, support training and supervise health workers.