Malaria in pregnancy services need strengthening in Nigeria

We have discussed recently about the challenges of delivering malaria control services in Nigeria when the primary health care system is weak. Kayode Osungbade and colleagues have reinforced that concern in reporting on exit interviews among 390 women at 12 antenatal clinics in southwest Nigeria. Some key malaria-related findings included –

  • less than half of the participants, 167 (42.8%), had either haemoglobin or packed cell volume estimated
  • malaria prophylaxis were given to 25 (6.4%) pregnant women

In addition, “Majority of the respondents, 279 (71.5%), were in their second trimester at the time of booking, whereas 83 (21.3%) and 28 (7.2%) booked in their third and first trimesters, respectively.” No mention was made about pregnant women receiving insecticide treated bednets, but if such were available, this intervention would miss a crucial time for preventing malaria – the first trimester – when IPTp cannot be given.

Jhpiego recently completed a malaria in pregnancy household survey of over 1,000 recebtly pregnant women in seven local government areas of Akwa Ibom State in the southeastern part of Nigeria. Those preliminary results were not encouraging either.

  • 5.1% of ANC clients received two doses of IPTp under direct observation

  • Only six (15.4/%) ANC providers reported having seen the national MIP guidelines at their facilit

  • 23.4% women who delivered in the past six months reported they slept under an ITN during their most recent pregnancy

The challenges of integrating malaria control into pregnancy remain high in Nigeria.  Better collaboration is needed between malaria control and maternal and child health staff at local, state and national levels to ensure lives of women and their unborn children are saved.

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