As we gear up to celebrate World Malaria Day this Saturday, April 25th, we’ll be featuring posts that highlight work currently happening to protect women and their babies from malaria in pregnancy.
For any expecting mother there are many things to worry about – from ensuring her growing baby’s health to making preparations to welcome him or her into the world. Imagine if one of those concerns was malaria. For the 1.6 million Ugandan women who live in areas where malaria is endemic, contracting malaria while pregnant is a dangerous reality.
Malaria in pregnancy, or MiP, significantly increases the risk of serious health issues for both mother and baby, including maternal anemia, miscarriage, stillbirth, prematurity and low birth weight. Since 2001, the government of Uganda has been making strides to include malaria prevention for pregnant women in their health policies. In fact, they integrated a MiP policy into national malaria guidelines in 2011. However, the policies were loosely coordinated, not fully implemented and did not reflect the World Health Organization’s (WHO) 2014 revised recommendations for preventing MiP with a package of key supplies and interventions.
One of the WHO-recommended supplies is a simple, cost-effective antimalarial drug called sulfadoxine-pyrimethamine that is used for intermittent preventive treatment in pregnancy, or IPTp-SP. In Uganda—even though 90 percent of pregnant women receive antenatal care—40 percent of those women do not receive this preventive treatment at the recommended level. WHO’s new guidelines increased the recommended preventive drug’s dosage for pregnant women from three doses to seven, creating an even wider gap in protection for expecting Ugandan mothers.
A group of advocates, led by PATH and including WHO, Jhpiego, CHAI, and the President’s Malaria Initiative, knew that if Uganda’s MiP policy could be better coordinated and updated to align with global standards, it could help reduce malaria rates among pregnant women.
The advocates sought to achieve these system improvements in three stages:
- Research and map MiP policies and responsibilities across government programs and departments to identify policy obstacles or gaps and identify key decision-makers and influencers
- Form an Action Group to develop a shared vision for MiP prevention across multiple governmental departments and define roles for MiP work within the Ministry of Health
- Convene the government’s existing Maternal and Child Cluster working group to draft an addendum that would align Uganda’s policies across government ministries and update the recommended IPTp-SP dosage to match global recommendations
The result of this advocacy work was a health triumph. The Ugandan government adopted this important addendum as national policy early this year. The advocates played a critical role by speeding up an otherwise lengthy process through active coordination and compiling and sharing evidence to convince policymakers that an innovative preventive treatment would improve health outcomes.
The policy adoption makes MiP prevention a national priority and will ultimately help remove the burden of malaria among expecting mothers in Uganda.
No woman should have to worry about malaria during pregnancy. Thanks to the Ugandan government, strong advocates and a simple drug with a complex name, Uganda is now on track to making that vision a reality.
This post is part of the blog series “Increasing access to maternal and reproductive health supplies: Leveraging lessons learned in preventing maternal mortality,” hosted by the Maternal Health Task Force, Reproductive Health Supplies Coalition/Maternal Health Supplies Caucus, Family Care International and the USAID-Accelovate program at Jhpiego which discusses the importance and methods of reaching women with lifesaving reproductive and maternal health supplies in the context of the proposed new global target of fewer than 70 maternal deaths per 100,000 births by 2030. To contribute a post, contact Katie Millar.