Augustine Ngindu, Sanyu Kigondu, Rose Mulindi, Christine Ayuyo, Muthoni Magu-Kariuki, Isaac Malonza, Julius Kimiteiand Elizabeth Washikaof Jhpiejo, the Ministry of Health (Kenya) and the Maisha/USAID Project reported on using Community Health Workers to identify and refer pregnant women to access intermittent preventive treatment (IPTp) in Kenya
Malaria in pregnancy is associated with anemia, low birth weight, miscarriages and death. Despite availability of effective MIP interventions intermittent preventive treatment using Sulfadoxine Pyrimethamine (IPTp-SP) and insecticide treated nets (ITNs), coverage rates in Kenya have remained low; IPTp2 uptake- 25% and ITN coverage- 41%.
To increase coverage rates Kenya has adapted a community strategy approach sensitizing pregnant women to start antenatal care (ANC) early to receive comprehensive care throughout pregnancy. This includes access to an ITN at first ANC visit and IPTp uptake beginning in the second trimester to increase coverage rates.
Trained community health workers (CHWs) registered pregnant women in their Community units for follow up monthly. CHWs conducted monthly follow up of all registered pregnant women to identify those not attending ANC and referred them for ANC services as well as counseled those not using ITNs.
CHWs received supportive supervision from district managers and MCHIP staff to assess performance skills on quality of data and mentorship on MIP interventions. Data collected was analyzed for pregnant women registered, accessing IPTp and referred for ANC services.
3,212 pregnant women were registered and 1,541 (48%) of the registered pregnant women were referred for ANC services because they were either late in starting ANC attendance or IPTp after 1st trimester or defaulters of scheduled visits. Among the registered pregnant women 81% had taken one or more IPTp doses.
Use of CHWs in identification of pregnant women not accessing IPTp and referral of 48% of them has shown an effective methodology of identifying defaulters in IPTp uptake among pregnant women. Scaling up of this community-based approach would ensure early ANC attendance and access to the available effective MIP interventions including IPTp.