Gestational malaria is a public health problem, thus responsible for morbidity and mortality risk to both the foetus and the mother. The intermittent preventive treatment with sulfadoxine-pyrimethamine during pregnancy (IPTp-SP) is one of the strategies recommended by the WHO to prevent this pathology and its consequences during pregnancy. In Benin, the adherence rate remains below the programmatic targets. This study aimed to identify the factors associated to the adherence to at least two

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... -SP doses for postpartum women of the University Hospital HKM of Cotonou (CNHU-HKM) and the University Hospital for Mother and Child (CHU-MEL) of Cotonou. Methods: A cross-sectional hospital-based study was conducted over a 3-month-period, from July to September 2015 in the field of gynaecology and obstetrics departments of the two hospitals. All the mothers who had delivered and were still hospitalized at the time of the study were enrolled. Results: During their last pregnancy, 63.11% of women had taken at least two doses of IPTp-SP. Four determinants of adherence to the two IPTp-SP doses were associated to the adherence to two doses of IPTp-SP: i) adequate knowledge of the number of doses of SP to be taken during the pregnancy (p-value<0.0001), ii) participation in communication for social and behavioural change on IPTp-SP (p-value<0.0001), iii) adequate knowledge of the number of tablets per dose of SP (p-value=0.0100), and iv) comprehensive knowledge of malaria prevention measures during pregnancy (p-value=0.0200). Conclusion: Raising and improving women's knowledge on malaria are necessary to achieve ITPp-SP adherence. Particular emphasis should therefore be placed on communication for social and behavioural change for pregnant women, family decision-makers, community leaders and healthcare workers. The Open Public Health Journal, 2018, Volume 11 35 evidenced by the WHO 2014 World Malaria Report [1], which found that poverty was the main determinant of nonadherence to IPTp-SP. Age below 20 years, lack of formal education, rural life and parity superior to one were also identified as negative influences on IPTp-SP adherence. On the other hand, a study carried out in Nigeria in 2010 showed that the primiparae adhered better to the IPTp-SP compared to the secondipares and the multipares [14] . In Uganda between 2008 and 2009, a cross-sectional study on 500 women who were pregnant the previous year revealed that women were more likely to observe IPTp-SP if administered during the prenatal consultation [26] . CONCLUSION The study found that raising and improving women's knowledge on malaria are necessary to achieve ITPp-SP adherence. Particular emphasis should therefore be placed on communication for social and behavioural change on pregnant women, family decision-makers, community leaders and health workers. ETHICS APPROVAL AND CONSENT TO PARTICIPATE The study was conducted in two gynaecological and obstetric departments in Cotonou: the University Clinic of Gynaecology and Obstetrics (CUGO) of the National University Hospital of Cotonou (CNHU-HKM) and the Gynaecology and Obstetrics Department of the Mother and Child Lagoon Hospital (CHU-MEL). The CNHU-HKM and the CHU-MEL are the two referral centres for Gynaecology and Obstetrics in Benin. HUMAN AND ANIMAL RIGHTS All human research procedures followed were in accordance with the ethical standards of the committee responsible for human experimentation (institutional and national), and with the Helsinki Declaration of 1975, as revised in 2008. CONSENT FOR PUBLICATION All the women have given free and written consent to take part in the study.