A poster entitled “Community health: Improving start of IPTp early in second trimester through promotion of MIP at the community level in Kenya” was presented by Augustine Ngindu, Gathari Ndirangu, E Nyapada, David Omoit, and Mildred Mudany from Jhpiego’s Kenya Team at the 65th annual meeting of the American Society of Tropical Medicine and Hygiene in Atlanta. The abstract follows …
WHO policy recommends that pregnant women living in moderate to high malaria transmission areas start receiving intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine pyrimethamine (SP) early in second trimester to prevent malaria in pregnancy (MIP).
In Bungoma County, Kenya, 52% of pregnant women start IPTp in their third trimester. Between June and September 2015, 197 Community Health Assistants (CHAs) were trained, who in-turn trained 2,344 Community Health Volunteers (CHVs) in Bungoma County.
Following the training, CHVs registered new pregnant women at their homes and encouraged them to seek antenatal care (ANC) and start taking IPTp early in the second trimester. The CHVs also helped to identify previously registered women who were not attending ANC and refer them to ANC for MIP services.
The CHVs, with CHA supervision, reached 44,133 pregnant women with MIP messages on starting IPTp early in the second trimester and use of a net. Data from 70 health facility registers was collected biannually and showed a 12% increase (24%-36%) in the proportion of pregnant women starting ANC attendance ? 20 weeks of pregnancy between October 2014 and March 2016.
Although there was a decline in the proportion of women receiving IPTp-SP between October 2014 and January 2015 and between October 2015 and February 2016 due to SP stock-outs, this did not significantly affect ANC attendance. The 12% increase in early ANC attendance is likely associated with CHV efforts in sensitizing women to start IPTp early in the second trimester and indicates a positive change in health seeking behaviour that can be sustained over time provided the commodities are available.
The success with CHVs promoting MIP at the community level has led to it being replicated in three additional counties and it will be extended in phases in other malaria endemic counties.