For Dr Folake Adurogbola, working in the community to ensure the health of mothers and babies was a priority. The reality is that the consequences of malaria on pregnant women are lost to many, even though malaria tests and medications are free at many health facilities.

Pregnant women are particularly vulnerable to malaria when infected because pregnancy lowers a woman’s immunity, increasing the risk of disease, severe anemia and death. Malaria during pregnancy increases the risk of miscarriage, stillbirth, premature delivery and low birth weight, one of the main causes of infant mortality.

For many pregnant women, ignorance of the effects of malaria, poverty and mothers’ traditional beliefs about when a pregnant woman comes to the health facility for antenatal care continues to be a barrier to prevention and treatment of malaria, even though the treatment of these is free in many public health establishments.

“Many people believe that when they go to hospital they will spend a lot. They had forgotten that most of these tests, especially malaria tests, are free. Also, malaria treatment is free. Some organizations support free malaria drugs in the community,” said Dr. Adurogbola, Team Leader of Oyo State, APIN Public Health initiatives.

An increase in the number of contacts between health care providers and pregnant women creates opportunities to expand coverage of quality-assured “intermittent preventive treatment (IPT) in pregnancy” and antenatal care.

Generally, across communities, pregnant women’s perceptions of malaria and recommended malaria prevention interventions, which are an integral part of maternal and newborn health services, are low.

In some communities, people misinterpret the symptoms of malaria during pregnancy. “Once a woman misses her period, confirms she’s pregnant and then gets sick, she doesn’t even think about malaria. They associate the symptoms with pregnancy. They will stay at home, maybe go to pharmacies to get medicine, which negatively affects pregnancy,” said Dr Adurogbola.

According to her, body aches, headaches or high body temperature require testing to be sure that it is not malaria in pregnant women, especially in areas where malaria is endemic such as the country. Nigeria.

She added: “It is not in all cases that a high body temperature or feeling sick is confirmed as malaria. This is why the test is important to confirm that it is indeed malaria in order to obtain appropriate treatment. For example, they might have a headache which could simply be due to stress.

The World Health Organization’s recommendation that IPT-sulfadoxine-pyrimethamine (SP) is a safe and highly effective strategy to prevent malaria in pregnancy is supported by a wide range of evidence. However, access to preventive treatment throughout pregnancy remains low.

In 2019, there were approximately 373,000 pregnant women with malaria in Nigeria. Compared to the previous two years, the number of pregnant women with malaria has decreased. In 2017, they amounted to more than 480,000.

Despite this, only 57% of pregnant women had four or more antenatal visits in 2018. The states in Nigeria where over 90% of women had at least four antenatal visits were Osun and Ogun. On the contrary, in Zamfara and Bayelsa, this percentage was around 26%.

A baseline household survey conducted in 2008 by the Society for Family Health in 21 states in Nigeria on perceptions of the risk of malaria in pregnancy as it influences the receipt of intermittent preventive treatment among pregnant women, indicated that respondents who perceived malaria as a risk during pregnancy were almost twice as likely to receive IPTp.

Sleeping under an insecticide-treated bed net the night before the survey was associated with receiving IPT, as was enrollment in antenatal care (ANC) services. In addition, women who enrolled in antenatal care were six times more likely to receive IPT than those who did not enroll.

Dr Adurogbola, however, said pregnant women shouldn’t joke about malaria because it breaks down red blood cells in the body; they may not be able to eat and induce vomiting, which reduces blood volume or anemia and increases the risk of losing their unborn baby.

“This is exactly why a pregnant woman who refuses treatment for malaria risks losing her baby. We sensitize every pregnant woman to register in a government hospital or hospital where she can benefit from quality intermittent preventive treatment during pregnancy and antenatal care.

Dr Monday Famakin, Chief Medical Officer and Director of Primary Health Care for North Ibadan Local Government, said malaria is a problem during pregnancy as the parasite can lead to the death of her baby. This can lead to further complications in the unborn baby.

He said expectant mothers, especially in the early stages of pregnancy, should not avoid the use of malaria drugs if prescribed because it cannot lead to miscarriage as many believed in the community.

Dr Famakin added: “Rather, it is malaria that usually leads to abortion during pregnancy, especially if a pregnant woman has malaria in the first trimester. Malaria drugs are safe during pregnancy, whether in the first, second, or third trimester. In addition, there are malaria prevention measures such as the use of insecticide treated bed nets or the use of IPT that will help reduce their risk of contracting malaria. »

Studies of the acceptability of malaria prevention interventions often examine them in isolation from other interventions. There is a need to better understand women’s perceptions, acceptability and adherence to these interventions that are integrated with other health services offered to women, such as antenatal care services. This will increase the use of these services and ensure the safety of healthy mothers and babies.