Abstract
BackgroundTo improve the coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) in Africa, Medicines for Malaria Venture (MMV) developed, tested and validated a new packaging of sulfadoxine–pyrimethamine (SP), as well as specific communications tools designed to improve knowledge of IPTp and the motivation of women to adhere to it, particularly if it is distributed by community health workers (CHW).MethodsThis article describes and analyses the results of an empirical research carried out in the Democratic Republic of the Congo (DRC), Nigeria and Mozambique, to evaluate the perception and social acceptability of SP for healthcare providers, CHW and pregnant women, and to assess the ability of the new SP packaging and the communications tools to change their perception of SP and improve their attitudes towards IPTp.ResultsThe results indicate that SP’s new individual packaging was perceived by pregnant women and healthcare providers as a “hygienic” and “safe”, with a specific identity. The graphics used in IPTp communications tools were modified according to the respondents’ feedback to make them more culturally and socially sensitive, and then validated. However, although the new blister packaging and IPTp communications tools generated greater confidence and motivation, SP side effects as well as preconceived ideas, particularly regarding its efficacy, remain a challenge that must be addressed to improve IPTp acceptance and compliance by healthcare providers and pregnant women.ConclusionThis participatory approach to social research based on ongoing feedback to the graphic designer provided more empirical evidence to improve and adapt the textual and visual content of communication tools (SP blister packaging, leaflet, user guide) to local contexts and user preferences. Tested and validated in different socio-cultural and socio-political contexts, these tools provide a good basis for the promotion of IPTp in Africa.
Highlights
To improve the coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) in Africa, Medicines for Malaria Venture (MMV) developed, tested and validated a new packaging of sulfadoxine–pyrimethamine (SP), as well as specific communications tools designed to improve knowledge of Intermittent preventive treatment for malaria in pregnancy (IPTp) and the motivation of women to adhere to it, if it is distributed by community health workers (CHW)
Since 1998, the World Health Organization (WHO) recommends the administration of sulfadoxine-pyrimethamine (SP) for IPTp in all eligible pregnant women during antenatal care (ANC) visits, starting as early as possible in the second trimester of the pregnancy [1]
Study design The qualitative study combined in-depth individual interviews (IDI), focus groups discussion (FGD), and direct observations, which offers the advantage of crossreferencing what participants say about SP with their actual practices
Summary
To improve the coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) in Africa, Medicines for Malaria Venture (MMV) developed, tested and validated a new packaging of sulfadoxine–pyrimethamine (SP), as well as specific communications tools designed to improve knowledge of IPTp and the motivation of women to adhere to it, if it is distributed by community health workers (CHW). Malaria can lead to anaemia, maternal death, preterm delivery low birth weight, and stillbirths. Since 1998, the WHO recommends the administration of sulfadoxine-pyrimethamine (SP) for IPTp in all eligible pregnant women during antenatal care (ANC) visits, starting as early as possible in the second trimester of the pregnancy [1]. In 2012, SP combined with amodiaquine was introduced to prevent malaria in children in the Sahel regions where transmission is seasonal [4]. Due to its extensive use, parasites have become increasingly resistant to the drug in the context of treatment and the social acceptability of SP for IPTp has become problematic [5]
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