Community health workers can help protect pregnant women and their babies from malaria

Group well being staff could make a fantastic distinction in rising the variety of pregnant girls who obtain life-saving preventive antimalarial therapy, based on a examine performed in 4 sub-Saharan African nations and led by the Barcelona Institute for World Well being (ISGlobal), an establishment supported by “la Caixa” Basis.

The findings, revealed in The Lancet World Well being, will assist to information malaria management methods in pregnant girls and enhance maternal and toddler well being in malaria-endemic nations.

Malaria throughout being pregnant places the well being of each mom and youngster in danger. In 2020, an estimated 11.6 million pregnancies in Africa had been uncovered to malaria an infection, leading to 11% of neonatal deaths and 20% stillbirths. Because of this, the WHO recommends that pregnant girls obtain three doses of the antimalarial drug sulfadoxine-pyrimethamine (SP) throughout their antenatal visits in the event that they reside in areas with excessive to average malaria transmission. Nevertheless, the proportion of eligible girls receiving this intermittent preventive therapy (IPTp) stays unacceptably low in lots of nations.

An progressive, community-based strategy

The TIPTOP undertaking (Remodeling Intermittent Preventive Therapy for Optimum Being pregnant), co-led by Jhpiego and Clara Menéndez, Director of ISGlobal’s Maternal, Little one and Reproductive Well being Initiative, took an progressive “no missed alternative” strategy to extend IPTp protection: utilizing group well being staff, who’ve been proven to enhance the uptake of well being interventions similar to childhood immunizations. This implementation science undertaking happened in happened in Democratic Republic of Congo, Madagascar, Mozambique and Nigeria between 2017-2022. Collaboration with WHO and Medicines Malaria Enterprise had been a mainstay all through the undertaking life.

“This examine is the most important implementation undertaking carried out in collaboration with the nations’ ministries of well being, by which we concurrently evaluated the influence of group well being staff on IPTp protection and antenatal care attendance,” explains Raquel González, TIPTOP senior epidemiologist and lead writer of the examine. Within the undertaking, group well being staff recognized pregnant girls locally, supplied the required SP doses to eligible girls and referred them to the well being facility for antenatal care. Greater than 18,000 girls participated in 32 family surveys over three years to evaluate IPTp protection earlier than, throughout, and after the community-based supply strategy.

The outcomes present that IPTp protection elevated considerably after the community-based implementation in all examine nations, starting from 133.6% in Madagascar to 473% in Nigeria, the place protection elevated from 12.7% to 31.8%. Importantly, the strategy didn’t scale back antenatal care attendance. Quite the opposite, it elevated barely in most examine areas.

“These outcomes are strong and can assist to tell malaria management methods,” says Clara Menéndez. Roughly 10,000 pregnant girls and 200,000 of their newborns die every year from malaria, which signifies that rising IPTp uptake via group well being staff can save 1000’s of maternal and toddler lives in African nations.

“We’re delighted to see these community-led approaches making a distinction within the lives of 1000’s of pregnant girls. Past attaining targets, TIPTOP has underscored the essential function group well being staff play in supporting the well being of girls, the place they reside,” stated Elaine Roman, TIPTOP Mission Director. “This gives promise and alternative effectively past lifetime of undertaking; offering a sustainable and reliable pathway to enhance the well being of girls throughout a variety of challenges.”