Megan Fotheringham, Public Health Advisor, President’s Malaria Initiative

In the developing world, pregnancy is a dangerous time for women. In sub-Saharan Africa, malaria poses a major threat to the health of pregnant women and their developing babies; each year nearly 32 million pregnant women are at risk from this deadly disease. The dangers, which occur when malaria parasites infect the placenta, are serious and include maternal anemia, miscarriage, stillbirth, and low birth weight in newborns. The cost in lives and resources as a result of malaria infection places a heavy burden on families and national health systems.

Thankfully there is a solution. Women can reduce their risk of infection by taking an antimalarial drug as preventive treatment: intermittent preventative treatment for pregnant women or IPTp. For full protection, pregnant women take at least two doses of the treatment during pregnancy. In Africa, IPTp is widely available and usually given during routine antenatal care visits across the region. Despite this fact, IPTp rates are still surprisingly low.

The Kenyan government’s Division of Malaria Control recently found an innovative and simple way to respond to this problem and subsequently increased the percentage of women taking IPTp. In the Gem District of western Kenya, where only 7 percent of pregnant women received the recommended two doses of IPTp, the Government of Kenya teamed up with researchers from the Kenya Medical Research Institute and the U.S. Centers for Disease Control and Prevention to improve the use of IPTp.

With funding from the U.S. President’s Malaria Initiative, the researchers discovered one of the reasons for low compliance with recommended use was that health workers were confused about when to give IPTp. According to the official guidelines, pregnant women should only be given IPTp in their second trimester but the doses should be given at least 30 days apart. This is complicated by the fact that many women are not sure how far along they are in their pregnancy. In addition, a mother’s HIV status is also a factor in treatment protocol.

To address this confusion, the Government of Kenya piloted a simple approach.  They sent an official memorandum to all government health facilities located in the Gem District and followed up with supervisory visits. The memo clearly listed five key messages about IPTp and instructed health workers to comply with these simplified guidelines.

6 Comments

  1. medicated mosquito net manufacturer in Kolkata says:

    Thanks for sharing the post here. Keep up the good work. All the best.

  2. Godfrey M Mubyazi says:

    It is very good news to hear and appreciate, surely agencies like USAID and other bilateral and multilateral organizations have played an important role in supporting health systems of developing countries, both materials and technically. It is a responsibility and challenge for these countries to harnes this potential to strengthen their health systems, with much great attention to mechanisms that can contribute to eradication of diseases of poverty, including malaria. As a researcher in the field of malaria interventions, with particular experience in studying interventions intended to effectively control malaria in pregnancy (MIP), I feel very encouraged that research has contributed to creating evidence about the interventions that work in the real world.

    As for other mechanisms for scaling up IPTp coverage, I recall the intervention suggested by Dr. Anthony K. Mbonye of Uganda (my colleague) who views that using community resource persons such as TBAs, teachers, community health workers, etc., it would be possible to increase the proportion of the pregnant women accessing two doses of SP for IPTp.

    Sincerely,

    Godfrey M. Mubyazi, Ph.D
    National Institute for Medical Research (NIMR)
    Dar es Salaam
    TANZANIA

  3. leo martin | enamorar a una mujer says:

    in my country are not the types of diseases against malaria, do not understand how other countries are so common here die of diseases that are resolved falcilmente .. we have everything and others have nothing …

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