Malaria in Pregnancy Programs: A Three Country Synthesis of What’s Working and What Can Work Better

A Poster Presentation at the 61st Annual Meeting of the American Society of Tropical Medicine and Hygiene, 11-15 November 2012, Atlanta.

Elaine Roman1, Michelle Wallon1, Aimee Dickerson1, Bill Brieger2 1MCHIP/Jhpiego, Baltimore, MD, United States, 2Johns Hopkins University, Baltimore, MD, United States

mip-malawi.jpgMalaria in pregnancy (MIP) contributes to maternal anemia, which contributes to maternal death, stillbirth and spontaneous abortion as well as low birth weight. Each year, the World Health Organization (WHO) estimates that nearly 50 million women will become pregnant in malaria endemic areas; 10,000 of these women and 200,000 of their infants will die as a result of MIP.

As countries expand their prevention and control of MIP programs and work towards scale-up, there are critical lessons learned, as well as promising implementation practices that should be considered. Between 2010 and 2012 Jhpiego conducted MIP case studies in Malawi, Senegal and Zambia in order to gain a fuller understanding of best practices and remaining bottlenecks in MIP programming.

The case studies applied a MIP framework for analysis that looked at eight core MIP program areas: policy, integration, commodities, quality assurance, capacity building, community awareness, monitoring and evaluation, and financing. Several best practices in MIP programming were identified, including: a) roll-out of national MIP policies; b) and integration of MIP guidelines into pre and in-service training curriculua; c) integration of MIP services into antenatal care (ANC); d) community engagement.

Key bottlenecks identified include: a) lack of program coordination between reproductive health and malaria control units; b) weak quality assurance systems; c) heavy reliance on donor funding. In addition to informing future MIP programming in Malawi, Senegal and Zambia, the lessons learned and the subsequent recommendations can be applied to other countries, and the analytical framework used to inform and scale up their specific MIP programs.

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