By Elizabeth Bastias-Butler, Program Assistant for the Maternal and Child Health/Nutrition program at PATH
Malaria in pregnancy (MiP) is a substantial contributor to maternal and newborn morbidity and mortality throughout malaria-endemic areas of the world. In Kenya, intermittent preventive treatment of malaria in pregnant women with sulfadoxine-pyrimethamine (IPTp-SP, referred to hereafter as SP) remains well below the 80% target level coverage articulated in Kenya’s 2013 National Malaria Strategic Plan (NMSP). Even with Kenya’s adoption of SP as standard malaria preventive treatment in 1998, only 22% of pregnant women receive the recommended minimum 2-doses, despite high antenatal clinic attendance.
PATH is implementing project activities in Kisumu, Kenya, and collecting evidence in support of community-based approaches to SP uptake. In this program, community health workers (CHWs) identify pregnant women early in their pregnancy, encourage antenatal clinic visits, review the maternal health booklets of pregnant women in their catchment area, and provide them with any missing dosage of IPTp-SP. The data collected from these activities will support the Kenyan Ministry of Health (MOH) effort to revise the NMSP to allow CHWs to distribute SP to pregnant women by 2015.
I traveled with the project director, Michel Pacque to Kenya in November to meet with various stakeholders and potential partners in both Nairobi and Kisumu. This was my first experience in the field and a wonderful opportunity to immerse myself in the project.
We met with district and national MOH officials to share program progress and to advocate for increased resources for MiP activities. In preparation for the dissemination of program activity findings, we met with USAID, MACEPA, and other stakeholders to provide a programmatic update and to promote community-based MiP approaches.
We accompanied PATH Kisumu staff Isabella Nyang’au, Assistant Community Advisor, and Oscar Odunga, Child Survival Officer, to the health facility in Ober Kamoth and to the Rota Dispensary to meet with CHWs to discuss their perspective on community-based distribution of SP. The CHWs showed enthusiasm for distributing SP during their regular promotion of antenatal clinic visits, stating that it is an important task addressing a need in their community. The CHW support is crucial in promoting local ownership over the program activities and will continue the work. It was an amazing experience to see the work firsthand in the field and engage with the CHWs. The project team is optimistic about the data collected throughout the project and are looking forward to the next steps of influencing policy change to include community-based approaches in the Kenyan NMSP.