Table 4 Recommendations from study findings relating to the supply side

Stakeholders and coordination

Strengthen linkages between government and implementing partners

Encourage vertical integration of health programmes, e.g. malaria and maternal and child health

Policies and guidelines

Ensure implementation of the most recent WHO policy recommendation of monthly IPTp administration after the first trimester

Clarify policy of encouraging male involvement in ANC, ensuring women attending without their partners are not disadvantaged

Provision of ANC services

Ensure ANC is offered consistently in all health centres II, III, IV and hospitals as per national policy

Encourage professional behaviour among health workers to create a positive ANC experience for all clients

Provide incentives such as mosquito nets to encourage early and frequent ANC attendance

Supply chain

Consider supplying SP free-of-charge to private health facilities

Capacity building

Train health workers on malaria in pregnancy and IPTp to improve knowledge of the IPTp guidelines

Consider use of alternative, non-disruptive training methods

Provide guidance on differentiating between mild and severe side effects of SP and emphasize the importance of taking SP as directly observed therapy

Monitoring and evaluation

Ensure supply of standard recording and reporting tools to health facilities

Ensure forms are designed to capture all plausible scenarios

Improve health workers’ data management skills and provide clear guidelines with regard to recording conventions

In addition to assessing completeness and timeliness of reported facility-level data, feedback should also be provided with regard to data accuracy