Increasing Intermittent Preventive Treatment uptake through enhanced antenatal clinic service delivery to improve maternal and child health

In Mali, malaria affects over 600,000 births annually, of which 19.3%, 13.5%, and 54.0% ended in placental malaria, LBW and maternal anaemia respectively. Given the wealth of evidence on the serious consequences of MiP to both the mother and child, National Malaria Control program (PNLP) is committed to the new WHO policy on providing pregnant women with a minimum of 3 doses of IPTp-SP. Preparedness for national level implementation is underway, however in order to effectively implement this new policy the barriers identified in empirical studies in the country (see above) must be addressed. These multi-faceted barriers suggest a significant missed opportunity to deliver effective ANC services and IPTp-SP. Given the logistical, practical and financial challenges together with the context of Mali just emerging from a profound socio-political crisis, sound evidence is needed to provide the best opportunity of successful implementation of the new IPTp-SP policy. 

Based on the findings of previous studies in Segou District, Mali, we have identified several important implementation barriers to high coverage to ANC and IPTp-SP uptake thereby offering the opportunity to design and implement interventions to mitigate these challenges and improve coverage. From the provider perspective, major barriers to effective implementation of ANC and malaria in pregnancy (MiP) services were poor health worker adherence to national guidelines, drug stock-outs, high ANC user fees and access to communities living in remote areas.  From the user perspective, major barriers included poverty, geographical inaccessibility, perceived poor quality of ANC services, and lack of knowledge on the importance of ANC and IPTp interventions. 

This is a three-arm, cluster-randomised intervention study at health facilities and their catchment communities (clusters) representing the health administrative subdivision in the district of San, Mali.  The interventions will target healthcare providers from selected ANC facilities. At the community level, the study will target non-pregnant women of child bearing age, pregnant women attending ANC and delivery, their husbands and mothers-in law, and other family members. 

Drug-based Strategies
Health Systems
Vulnerable Populations

Mar 2019 — Mar 2021

$400,000

Mali

Intermittent preventive treatment in pregnancy (IPTp)