Assessment of the consistency of national-level policies and guidelines for malaria in pregnancy in five African countries

Publish Date: June 2014
Author: Patricia Gomez, Julie Gutman, Elaine Roman, Aimee Dickerson, Zandra Andre, Susan Youll, Erin Eckert, Mary Hamel
Language: English

One of the major factors contributing to low coverage of long-lasting insecticide-treated bed nets (LLINs) and intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP) among pregnant women is provider confusion about when and how to distribute them. Technical expertise in malaria in pregnancy (MIP) is typically provided by national malaria control programs (NMCPs), while MIP interventions are implemented through national reproductive health (RH) programs. Collaboration between these two programs is critical to ensuring consistent MIP guidance and quality MIP services.

To better understand the related guidance countries are promoting for health workers, the authors of a newly published article in Malaria Journal conducted a review of national-level MIP policies, guidelines and training documents from NMCPs and RH programs in Kenya, Mali, Mozambique, mainland Tanzania and Uganda.

The MCHIP co-authored article, entitled “Assessment of the consistency of national-level policies and guidelines for malaria in pregnancy in five African countries,” recommends that national MIP documents be updated and ensure consistency, and that health workers be re-oriented and supervised to accelerate implementation of the latest World Health Organization MIP policy recommendations.

All five countries had national documents promoting IPTp-SP, LLINs and MIP case management, but most recent World Health Organization guidance frequently was not reflected. In all countries, inconsistencies between NMCPs and RH programs on timing or dose of IPTp-SP were documented, as was the mechanism for providing LLINs. Inconsistencies were also found in training documents from NMCPs and RH programs. Outdated, inconsistent guidelines have the potential to cause confusion and lead to incorrect practices among health workers who implement MIP programs, contributing to low coverage of IPTp-SP and LLINs.

To read the open access article, click here.