Intermittent Preventive Treatment, a Key Tool to Prevent and Control Malaria in Pregnancy

We already have a highly cost-effective tool with proven efficacy in preventing malaria during pregnancy and reducing newborn deaths: IPTp-SP Malaria in pregnancy is one of the leading indirect causes of maternal mortality. In sub-Saharan Africa, over 15% of maternal deaths are associated with malaria infection during pregnancy. The infection puts pregnant women and their babies at high risk for complications, especially maternal anaemia and infection of the placenta. Low birth weight and preterm birth are other consequences of malaria infection during pregnancy. Despite progress in the deployment of existing control strategies, such as the use of mosquito nets impregnated with long-lasting insecticides, intermittent preventive treatment (IPT) during pregnancy with sulfadoxine-pyrimethamine (SP), and prompt and effective treatment of malaria cases, malaria in pregnancy is still responsible for 400,000 cases of severe maternal anaemia, 10,000 maternal deaths, and the death of 200,000 newborn babies every year .

We already have a highly cost-effective tool with proven efficacy in preventing malaria during pregnancy and reducing newborn deaths: intermittent preventive treatment during pregnancy with sulfadoxine-pyrimethamine (IPTp-SP), an intervention recommended by the World Health Organization. The administration of IPTp-SP during pregnancy to women living in areas of stable (high) malaria transmission can reduce neonatal mortality by more than 60% . However, while IPTp-SP is an official component in the health policies of over 30 African countries, the reality is that actual coverage is very low and it has been estimated that only 25% of pregnant women at risk for malaria infection receive at least one dose of IPTp-SP.

It has been estimated that only 25% of pregnant women at risk for malaria infection receive at least one dose of IPTp-SP The control of malaria in pregnancy will depend on our ability to significantly increase the coverage of this effective intervention. And how can this be achieved? A coordinated approach is needed to scale up coverage of IPTp-SP. This has been demonstrated by the experience of the countries currently making the most progress. There is an urgent need to intensify prevention efforts with the commitment of malaria-endemic countries so as to ensure that the WHO recommendations are successfully implemented by national malaria programmes. IPT should be seen as a key intervention in all prevention strategies. To ensure access to IPT, it will also be essential to strengthen the capacity of health systems, to implement evidence-based policies, and to identify the cultural and operational barriers that are currently hindering the administration of IPT and/or it acceptance, thereby preventing this essential treatment from reaching those who need it—pregnant women in areas of high malaria transmission.

Malaria in pregnancy must be a priority issue on the health agenda currently being drawn up in the context of the Sustainable Development Goals (SDG) because it is one of the factors that has prevented greater improvement in maternal and child health indicators ( MDGs 4 and 5). Promoting this intervention aimed at preventing malaria in pregnancy will definitely continue to be a priority for us at ISGlobal, both in the Maternal, Child and Reproductive Health Initiative and in the work we do with our partners in the Malaria in Pregnancy Working Group of Roll Back Malaria to improve and increase the coverage of malaria control measures during pregnancy.

Learn More

Malaria in Pregnancy: Intermittent Preventive Treatment Fact Sheet

[This entry is the first of the #DefeatMalaria World Malaria Day 2015 blog series]