Despite current efficient antenatal care strategies malaria and anaemia prevalence at term are 12.1% and 45.9% respectively. Encouraging pregnant women to participate in management of malaria and anaemia using simple tools will improve adherence to recommendations by antenatal care staff and improve maternal haemoglobin and pregnancy outcomes.
The study involved mapping of antenatal clinics in 2 districts, conducting observational studies in the largest 18, selecting and grouping of 14 into intervention and control arms based on size, type of antenatal care services and location, conducting baseline study among 570 pregnant women to determine malaria and anaemia prevalence and associated risk factors, developing guides and training staff for the enhanced antenatal care. Recruitment of pregnant women for the trial is on-going. The results below are from the baseline study.
Malaria and anaemia prevalence was 15.5% and 42.6% respectively. Women of parity ≤1 were at a higher risk of parasitaemia compared to those of parity ≥ 2 [RR=1.7, (95% CI; 1.12-2.49) p=0.012]. The average age and haemoglobin concentration of the women with parasitaemia were significantly lower [25.1 (6.2) yrs vs. 27.4 (6.2) yrs; p=0.007] and [10.5 (1.4) g/dl vs. 11.2 (1.3) g/dl; p<0.0001) than in those with no parasitaemia. IPTp-SP, ITN use and self-reported adherence to iron and folate supplementation did not seem to have any significant effect on parasitaemia and anaemia.
Malaria and anaemia are still prevalent. New ways to facilitate the delivery and uptake of ANC strategies need to be explored.