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Malaria infection in pregnancy is a major cause of maternal death, maternal anaemia, and other adverse pregnancy outcomes. The World Health Organization (WHO) in 2018 estimated that 11 million pregnant women were infected with malaria in areas of moderate and high disease transmission in sub-Saharan Africa. As a result, nearly 900,000 children were born with a low birth weight. It is therefore recommended by the WHO that countries prioritize controlling malaria and its effects during pregnancy.

HFFG with the support of the National Malaria Control Programme, implemented the Malaria Control Project in collaboration with the Twifo Atti-Mokwa District Health Management Team under the National Malaria Control Programmes. The goal of the project was to minimize malaria-related morbidity and mortality burden in the country, especially among pregnant women. The project lasted from July 2021 to December 2021.The implementation took place in 15 communities with high malaria prevalence namely; Kayireku, Mbaabasa, Somnyamekodur, Bepobeng, Moseaso, Nyinase, Abodom, Aboabo, Nyinase Kojokrom, Nuamakrom, Bimpong Egya, Wamaso, Mampoma and Eduabeng.

To achieve the goals of the project, Community Based Agents (CBAs) were selected and empowered to provide community level sensitization on malaria control interventions using the available systems. The CBAs as part of their work identified and linked them to health facilities for to Intermittent Preventive Treatment services.

The agents also sensitized and followed up on the pregnant women to ensure adherence to uptake of Intermittent Preventive Treatment for Pregnant Women.  Emerging issues were discussed with stakeholders to resolve them and documentation of best practices.

Hawa, a 22 year old native of Twifo Atti-Mokwa district in the Central region of Ghana was one of the women identified by a CBA. Hawa was suffering from epilepsy right from her childhood and this condition affected her social life. In her first pregnancy, she could not receive and participate in the prenatal care services due to the fear that receiving any of medication could worsen her condition and may facilitate numerous complications. Unfortunately, she lost the baby. “My first pregnancy was lost due to frequent falling and injuries as a result of seizure episodes and loss of consciousness but when I got pregnant for the second time, I was identified by a community based agent under the Malaria Project by HFFG”, Hawa narrated. “The Community Based Agent came to our house one day to educate us about the malaria control interventions and when she realized that I was pregnant, she advised me to start antenatal clinic as soon as possible to receive medical attention and be guided by a health practitioner.”

With the help of the CBA and the HFFG project team, Hawa started attending clinic at Nyinase Community Health-Based Planning Services compound. She was provided with Intermittent Preventive Treatment therapy and subsequently referred to the Twifo Praso Government hospital to receive special medical attention till she successfully gave birth to a set of healthy twins.

“I never experienced malaria infection nor seizure crises throughout my second pregnancy. I completed all my Intermittent Preventive Treatment dosages and also slept consistently under treated mosquito net without any complications. Now I have given birth to beautiful healthy twins. I am grateful to the malaria project team for checking up on me regularly”.

Within the duration of the project, 191 pregnant women from the beneficiary communities were identified and reached with malarial prevention information by the project team. In total 38,033 individuals were reached through various means including (house-to-house, churches, schools, mosques, mobile van announcement, community information centres, community centres, video shows and durbar sensitizations) and through one-on-one education and group discussions.

Children under age five are the most vulnerable to malaria infection. In 2019, the World Health Organization (WHO) estimated that they accounted for 67% (274 000) of all malaria deaths worldwide.

Intermittent Preventive Treatment of Malaria in Pregnancy with Sulfadoxine-Pyrimethamine (IPTp-SP) for Pregnant Women has been identified to decrease placental parasitaemia and improves birth outcomes.

For this reason, HFFG as a partner of the Ghana Health Service in implementing the National Malaria Control Project in Twifo Atti-Mokwa District in the Central Region has vigorously been reaching out to pregnant women to visit health facilities for their Sulfadoxine-Pyrimethamine (SP) doses to ensure that their unborn babies are protected from malaria.

Expectant mothers are encouraged to get early and regular prenatal care as it helps decrease the risk of complications during child birth. Thus, it enables health care providers to identify, diagnose and treat or manage conditions before they become serious.

As part of activities to help achieve the goals of the project, HFFG Project staff paid a working visit to Twifo Eduabeng CHPS compound to engage with the Ghana Health Service Staff in charge of the facility to receive update on SP uptake and other related issues. 

During the visit, it was realized that, in as much as many pregnant women were visiting the health facility for care, some were defaulting in taking their medications, hence the need for more sensitization and awareness.  

What can be done to protect pregnant women and unborn babies?

  • HFFG Project staff together with the Health Officer in charge of the facility have established a pregnancy school which will give psychosocial support, intensify education on malaria control interventions, socio-economic empowerment and other relevant activities. 
  • Another strategy is the involvement of pregnant women spouses in pregnant school to help improve attendance and SP uptake.  During the school sessions, gifts are awarded to regular attendees to motivate mothers to do same. Additionally pregnant women who provide right answers to questions are also rewarded.