Addressing Malaria in Pregnancy:  Improving the Odds for Mothers and Newborns

Session: Know your Epidemiology and Respond Accordingly: Addressing HIV, TB and Malaria to Ensure Healthy Pregnancy

Presenter:  Mary Nell Wegner, Maternal Health Task Force, Harvard T. H. Chan School of Public Health
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Background: Although there have been significant gains in the prevention and treatment of malaria, pregnant women and newborns remain highly vulnerable. While over 30 African nations have adopted IPTp, in addition to use of long lasting insecticide-treated bednets and effective case management for pregnant women, coverage is well below Roll Back Malaria’s 80% target for 2015. The most recent World Malaria Report notes that 15 of the 35 million pregnant women at risk for malaria did not receive even one dose of intermittent preventive treatment (IPTp) in 2013. The consequences are not surprising: in sub-Saharan Africa, over 400,000 cases of maternal anemia; 15% of maternal deaths; and 200,000 newborn deaths were associated with malaria infection.

Methods: In Ghana and Zambia, based on qualitative interviews with Ministries of Health, donors and supporting partners as well as review of national level country reports, key practices in malaria in pregnancy success were determined. Effective integration of MNH and malaria in pregnancy from Ghana and Zambia will be reviewed with emphasis on strengthening the antenatal care platform.

Results: Both Ghana and Zambia have achieved high coverage of ITPp; 65% and 70% respectively. As WHO revises global antenatal care guidelines and Rollback Malaria’s Call to Action for IPTp is launched, the time is now to pioneer new approaches across the continuum of care- from community level to facility level to national level- to meet pregnant women and newborns’ needs.

Conclusions: Clearly, it is time to consider how to meet mothers’ and newborns’ needs better and redesigning the antenatal care (ANC) platform, including forging creative partnerships, offers an opportunity to do so. The challenge is how to provide these services in a way that is compelling to women and possible for providers and health systems.