Following WHO’s 2012 updated guidance on intermittent preventive treatment of malaria in pregnancy (IPTp), the 2015 Global Call to Action to scale-up IPTp coverage, and the 2016 WHO ANC guidelines, 23 President’s Malaria Initiative (PMI) focus countries were surveyed on their malaria in pregnancy (MIP) programs.
To complement the survey results, we conducted an in-depth desk review of programs in 12 countries (Angola, Benin, Burkina Faso, DRC, Ghana, Kenya, Liberia, Madagascar, Malawi, Nigeria, Senegal, Zimbabwe) . These countries actively implement IPTp programs and are at various stages of MIP program scale up. Briefs document IPTp policy and implementation status, routine health system and household survey trends for antenatal care, IPTp, bednet use, community initiatives and interventions, and the inclusion of MIP indicators (including case management) in health management information systems, and highlight aspects of MIP programs that could be strengthened or expanded.
Eighteen PMI countries are implementing IPTp; 15 have updated policies following the 2012 WHO IPTp guidelines, however, in three countries, Malaria Control and Reproductive Health policies provide conflicting recommendations about IPTp initiation. Identified challenges include conflicting malaria and reproductive health program IPTp policies, missed opportunities to reach women attending ANC, MIP commodity stockouts, and delays aligning routine MIP indicators with updated IPTp policies. National programs could be improved by better defining and aligning IPTp policies across malaria and reproductive health programs, inclusion of key MIP indicators in routine reporting systems including standardization of reported indicators, alleviating supply chain bottlenecks, and engaging communities. Scale up could be facilitated with a variety of country-appropriate community level approaches.
By defining the key challenges and developing recommendations, these profiles will assist countries to strengthen programs to minimize the impact of MIP, and improve outcomes for women and children.