Table 5 Opportunities for intervention to improve intermittent preventive therapy in pregnancy uptake
| Â | Level of intervention | ||
|---|---|---|---|
Barrier to IPTp uptake | Individual | Community | Environment |
Understanding of MiP | Emphasize the importance and benefits of timely treatment of malaria with ACT, rather than herbal medicines to women and their families. | Emphasize the importance and benefits of timely treatment of malaria with ACT, rather than herbal medicines to women and their families. | Develop and disseminate effective job-aids for providers on focused ANC and MiP protocols. |
Partner with CHWs to reach and inform women and their families on ACT. | |||
Understanding of IPT | Develop lower literacy information packets to explains dosage and timing for women given prescription for SP. | Develop lower literacy information packets to explains dosage and timing for women given prescription for SP. | Provide supportive health care supervision to ensure that providers and CHWs follow MiP protocols. |
Costs of seeking care | Emphasize lower cost of preventing malaria compared to treating malaria or complications (such as low birth weight infant) | Emphasize lower cost of preventing malaria compared to treating malaria or complications (such as low birth weight infant) | Ensure that only allowable fees are charged. |
Waiting time | Identify and promote specific day of the week as “malaria treatment day” to ensure attendance and speedy services delivery. | Identify and promote specific day of the week as “malaria treatment day” to ensure attendance and speedy services delivery. | Provide appropriate staffing to ensure timely services delivery on “malaria treatment day” and reduce waiting time. |
Client-provider interaction | Encourage women seeking MiP services to ask questions and interact with providers. | Include messages encouraging women to ask providers questions in BCC campaigns | Improve provider IPC skills through short, intensive training with role plays to enable providers to see patient’s perspectives. |
Availability of SP on-site | NA | NA | Improve supply-chain management. May require a more inclusive facility-level and mobile drug distribution processes. |
Women, Families and Community | Encourage women and families to see benefits rather than barriers to preventive MiP care seeking behaviours. | Reinforce existing beliefs and behaviours to prevent and manage MiP | Engage influential community members to encourage prevention and management of MiP |