Antenatal Care (ANC) &ITNs &Malaria in Pregnancy Bill Brieger | 02 Nov 2022 09:59 am
Improving insecticide treated net coverage through antenatal care services in Rwanda
Jean Louis Ndikumana Mangara, Marcel Manariyo, Michée S. Kabera, Yvette Muyirukazi, Jean Modeste Harerimana, Christine Mutaganzwa, Marie Rose Kayirangwa, Noella Umulisa, Aimable Mbituyumuremyi report on Improving insecticide treated net coverage through antenatal care services in Rwanda at the 2022 Annual Meeting of the American Society of Tropical Medicine and Hygiene.
Malaria in pregnancy (MIP) negatively affects pregnancy outcomes, including maternal and neonatal mortality and adverse fetal outcomes such as low birth weight. Therefore, among other malaria prevention interventions, Rwanda embarked to achieve the insecticide treated net (ITN) universal coverage through the ITN mass distribution to households and routine distribution to the most vulnerable groups including under five children and pregnant women.
In the period of Jan 2020 to Dec 2021, the program improved ITN distribution and the information, education and communication on challenges related to malaria behavior during ANC visits and conducted capacity building of health care providers on malaria diagnostic and case management training, integrated malaria supportive supervision, monthly data review and validation meetings at health facilities and monitoring of use of ITN program at health facility level.
A quarterly review of data from national Health Management Information System (HMIS) on ITN distributed during ANC services and changes in MIP incidence was done in the period of January 2020 to December 2021. The results show an increase from 49% (z-score (-0.8)) (Jan-Mar 2020) to 74% (z-score 0.5) (Oct-Dec 2021) coverage in the distribution of ITN among pregnant women during ANC visits.
There was a decrease in malaria incidence from 65 (z-score (2)) to 17 (z-score (-1)) cases among pregnant visiting ANC services, and a decrease from 88 to 73 malaria cases in all (567,198) pregnant women for10,000 confirmed malaria case during the January-March 2020 to October-December 2021. There has been a moderate negative correlation between the proportion of pregnant women receiving ITN in ANC services and the proportion of malaria cases in pregnancy every quarter r(9) = -0.655, P (value)=0.056.
Although malaria cases among pregnant women have declined and the distribution of ITN in ANC services increased over the studied period, there is a need to strategize innovation to reach the remaining pregnant women.