Aim: Jhpiego, in partnership with Unitaid, is introducing an innovative no-missed opportunities approach to increase coverage of IPTp3 with quality assured sulfadoxine-pyrimethamine (SP) to at least 50% (currently 19%[i]) of eligible pregnant women, in project sites, in Democratic Republic of Congo, Madagascar, Mozambique and Nigeria. The project, Transforming IPTp for Optimal Pregnancy (TIPTOP) will support community-level distribution of quality assured SP (C-IPTp), complementing delivery at antenatal care (ANC). TIPTOP will target pregnant women in their communities, especially among those hardest to reach to help ‘bend the curve’ for better coverage and improve prevention of malaria in pregnancy (MiP). This project will generate evidence for World Health organization review and set the stage for scale up, working closely with Ministries of Health and partners to engender successful handover.
Methods: The TIPTOP project has 2 phases. In each target country, phase 1 will focus on the introduction of C-IPTp in one district and phase 2 will expand C-IPTp in 2 additional districts. TIPTOP will support country plans through supplemental training, supervision and coordination efforts as well as communication efforts to achieve.
Results: In Year 1, TIPTOP has conducted a rapid facility assessment in 140 facilities in implementation areas. The assessment focused on: facility readiness, ANC provider knowledge and perceptions related to MiP, national system data quality, and existing linkages between facilities and community health workers. The assessment found that over-reporting of ANC contacts and IPTp service provision is a data quality challenge. Additionally, the CHW cadre is quite varied in each country in terms of training, education and roles.
Conclusions: TIPTOP is a game changing project with the potential to increase IPTp coverage, influence global policy and set the stage for scale up across the region that will ultimately help countries achieve sustainable development goal-3.
[i] WHO. 2017. World malaria report 2017.