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Prevention and Control of Malaria in Pregnancy in the African Region

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Prevention and Control of Malaria in Pregnancy in the African Region P R E V E N T I O N A N D C O N T R O L O F M A L A R I A I N PREGNANC Y I N THE A FRIC AN R EGION A Program Implementation Guide P R E V E N T I O N A N D C O N T R O L O F M A L A R I A I N PREGNANC Y I N THE A FRIC AN R EGION A Program Implementation Guide For information: Jhpiego 1615 Thames Street Baltimore, MD 21231-3492, USA Tel: 410.537.1800 www.jhpiego.org Editor: Ann Blouse Graphic Design: Trudy Conley The ACCESS Program is the U.S. Agency for International Developments global program to improve maternal and newborn health. The ACCESS Program works to expand coverage, access and use of key maternal and newborn health services across a continuum of care from the household to the hospitalwith the aim of making quality health services accessible as close to the home as possible. Jhpiego implements the program in partnership with Save the Children, the Futures Group, the Academy for Educational Development, the American College of Nurse- Midwives and IMA World Health. www.accesstohealth.org Jhpiego is an international, non-profit health organization affiliated with The Johns Hopkins University. For nearly 40 years, Jhpiego has empowered front-line health workers by designing and implementing effective, low-cost, hands-on solutions to strengthen the delivery of health care services for women and their families. By putting evidence-based health innovations into everyday practice, Jhpiego works to break down barriers to high-quality health care for the worlds most vulnerable populations. March 2008 TABLE OF CONTENTS TABLE OF CONTENTS ............................................................................................................ iii ACKNOWLEDGMENTS .............................................................................................................v ABBREVIATIONS AND ACRONYMS................................................................................... vii SECTION 1: INTRODUCTION ..................................................................................................1 Purpose and Audience..........................................................................................................1 Overview: The World Health Organization Strategy for the Prevention and Control of Malaria during Pregnancy in the African Region................................................................2 Integration, Collaboration and Partnerships ........................................................................5 Current Status of Country MIP Policies and Programs .....................................................11 References for Section 1 ....................................................................................................17 Resources for Section 1 .....................................................................................................18 SECTION 2: ESSENTIAL COMPONENTS FOR IMPLEMENTING PROGRAMS.........19 Overview............................................................................................................................19 SECTION 2-1: TRANSLATE MIP POLICY INTO SERVICE DELIVERY GUIDELINES ..................................................................................................................20 Key Issues ..........................................................................................................................24 Country Example: Zambia.................................................................................................25 Resources for Section 2-1 ..................................................................................................28 SECTION 2-2: COMMODITIES...............................................................................................29 2-2.1: Ensure Appropriate Pharmaceutical Management for Preventing and Treating Malaria in Pregnancy ......................................................................................29 Key Issues ..........................................................................................................................36 Country Example: Ghana...................................................................................................37 Resources for Section 2-2.1 ...............................................................................................40 2-2.2: Ensure Distribution of Insecticide-Treated Nets for Prevention and Control of Malaria in Pregnancy..................................................................................................41 Education and Counseling .................................................................................................42 Forecasting, Procurement and Distribution .......................................................................43 Key Issues ..........................................................................................................................46 Country Example: Malawi ................................................................................................48 Resources for Section 2-2.2 ...............................................................................................51 SECTION 2-3: USE PERFORMANCE STANDARDS TO HELP ASSURE HIGH- QUALITY MIP SERVICES .......................................................................................................52 Key Issues ..........................................................................................................................56 Country Example: Madagascar..........................................................................................56 Resources for Section 2-3 ..................................................................................................60 Malaria in Pregnancy Program Implementation Guide iii SECTION 2-4: BUILD HUMAN CAPACITY THROUGH TRAINING TO ENSURE IMPLEMENTATION OF MIP GUIDELINES........................................................................61 Pre-Service Education........................................................................................................61 In-Service Training ............................................................................................................62 Key Issues ..........................................................................................................................65 Country Example: Kenya...................................................................................................66 Resources for Section 2-4 ..................................................................................................68 SECTION 2-5: MOBILIZE COMMUNITIES TO TAKE ACTION TO PREVENT MALARIA IN PREGNANCY....................................................................................................70 Community Action Cycle for Community Mobilization...................................................71 Key Issues ..........................................................................................................................77 Country Example: Burkina Faso........................................................................................78 References for Section 2-5.................................................................................................80 Resources for Section 2-5 ..................................................................................................81 SECTION 2-6: MONITOR AND EVALUATE PROGRAMS FOR PREVENTION AND CONTROL OF MALARIA IN PREGNANCY ........................................................................82 Developing a Monitoring and Evaluation Plan for MIP Programs....................................82 Selection of Indicators .......................................................................................................84 Output Indicators ...............................................................................................................85 Data Sources ......................................................................................................................86 Key Issues ..........................................................................................................................88 Country Examples: Uganda And Kenya ...........................................................................89 Overview of the Pilot Test .................................................................................................90 Summary of Findings.........................................................................................................91 Lessons Learned.................................................................................................................92 Reference for Section 2-6 ..................................................................................................93 Resources for Section 2-6 ..................................................................................................93 SECTION 3: PRACTICAL SOLUTIONS TO FREQUENTLY SEEN PROBLEMS..........95 Women Do Not Come Early in Their Pregnancies for ANC.............................................95 Women Are Not Given Antimalarial Drugs Recommended per National Guidelines or Do Not Use Them if They Are Available..........................................................................96 Women Are Unable to Obtain ITNs or Do Not Use Them if They Are Available. ..........97 Reference for Section 3......................................................................................................98 SECTION 4: FINANCING CONSIDERATIONS....................................................................99
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