In Burkina Faso, Antenatal Care (ANC) is a national platform for malaria in pregnancy prevention and control. The 2010 Demographic and Health Survey showed a good initial ANC registration rate (95%), but over 56% of pregnant women in rural areas do not register until their second or third trimester. Thus they may have missed the full regimen of ANC services including Long Lasting Insecticide-treated nets and intermittent preventive treatment of malaria in pregnancy (IPTp).
In 2010 only 10.6% of pregnant women nationally and 8.4% in rural areas received two doses of IPTp. Now WHO recommends more doses. This had improved by the time the 2014 Malaria Information Survey was completed to 68% for one dose, 48% for two and 22% for three doses.
Jhpiego’s USAID-supported Improving Malaria Care (IMC) project in Burkina Faso has been providing technical assistance and training to health districts and their ANC staff on implementing updated (2012) WHO IPTp guidelines. The recommended provision of IPTp at every ANC visit from the 13th week of pregnancy onward leads to the possibility of 3 or more doses per woman. The new guidance was incorporated into the update of Burkina Faso’s malaria strategy and has been disseminated since September 2014.
Annual data from the Health Management and information System for 2014 from three districts (Batie, Po and Ouargaye) and 61 health clinics where IMC has been working were collected and summarized. A total of 26,909 women registered for ANC our of the estimated 35,420 in the Three districts.
The chart at the left shows coverage of ANC visits and IPTp provision based on the estimated 2014 population of pregnant women in the districts. Eleven (17.7%) clinics had not started the updated IPTp guidance. The Ministry of Health also experienced stock-outs of sulfadoxine-pyrimethamine.
Being new IPTp3+ poses challenges and needs greater investment. The IMC project in collaboration with the National Malaria Control Program is examining ways to invest in stronger antenatal malaria prevention including capacity building for ANC staff and provision of IPTp by the existing network of volunteer community health workers.