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Gap in malaria treatment for pregnant women

The proportion of pregnant women in Sub-Saharan Africa receiving preventive measures such as intermittent preventive treatment for malaria during pregnancy (IPTp) is low, a study says.

According to researchers, pregnant women are at high risk of death from malaria and that about 125 million pregnancies occur annually in malaria-endemic areas, noting that a policy exists for pregnant women to receive IPTp during antenatal care (ANC) visits.

Researchers used data from 58 demographic and health surveys (DHS) conducted between 2003 and 2013 in 31 African countries including Burundi, Ethiopia, Ghana, Kenya, Madagascar, Rwanda, Tanzania and Uganda to assess trends in IPTp coverage and to establish potential areas of improvement.

The study published last month (23 December) in the Malaria Journal found that the proportion of ANC visits that were missed opportunities to deliver IPTp for between a quarter and three-quarters of the 31 countries ranged from 58.4 to 79.5% although the policy requires 100% coverage.

Kathryn Andrews, the study’s lead researcher from Harvard T. H. Chan School of Public Health in the United States, says the low IPTp coverage in households surveyed over a decade after its policy adoption implies deficiencies in implementation.

John Logedi, a deputy-director of medical services at Kenya’s Ministry of Health, says: ‘We still require that pregnant women in areas where malaria is a risk must get IPTp in addition to other interventions.’

Logedi agrees that the policy is not adequately implemented. ‘The health systems should move a step further and ensure IPTp is given to pregnant mothers and that documentation is done accordingly,’ Logedi said.

Stephen Kinoti, the vice-president, clinical solutions at US-headquartered Fio Corporation, which promotes integrated, health data use, lauds the study’s importance in highlighting areas of potential improvement for IPTp during antenatal care visits.

He suggests that providing automated guided care system during antenatal care visits, and adding essential services including embedded data capture could improve malaria control in pregnant women. It could also provide data on reasons for failure in the system.

‘This is an area of special need that can be addressed by better health information management (HIM) systems, which bring about technical and managerial transparency and accountability in service delivery,’ adds Kinoti.

According to Kinoti, data could be captured automatically as part of routine ANC service delivery and interconnected with the national HIM systems, which would allow for real-time support of communities, facilities and health workers providing these services.

However, Logedi and Kinoti add that the findings in the DHS based on recall of interviewees and their understanding of how the question on IPTp is framed could be a major limitation to the study.

References
Kathryn Andrews and others Missed opportunities to deliver intermittent preventive treatment for malaria to pregnant women 2003–2013: a systematic analysis of 58 household surveys in sub-Saharan Africa (Malaria Journal, 23 December 2015)

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk. See more at: http://www.scidev.net/sub-saharan-africa/malaria/news/gap-malaria-treatment-pregnant-women.html#sthash.ixv1onS1.dpuf

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