Factors Affecting the Delivery, Access, and Use of Interventions to Prevent Malaria in Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Abstract

Jenny Hill and colleagues conduct a systematic review and meta-analysis of qualitative, quantitative, and mixed methods studies to explore the factors that affect the delivery, access, and use of interventions to prevent malaria in pregnant women in sub-Saharan Africa. Please see later in the article for the Editors' Summary

Coverage and efficacy of intermittent preventive treatment with sulphadoxine pyrimethamine against malaria in pregnancy in Côte d¿Ivoire five years after its implementation

“…Consistent with other studies, our findings suggest that health provider practices rather than women's ANC attendance are primarily responsible for the ineffectiveness of the IPTp strategy in this setting [18,[21][22][23][24].…”

“…Stock outs of SP, absence of cups and clean drinking water for taking SP by DOT [17], unclear guidelines [21] or confusion among health workers regarding the guidelines [24] and other related health facility factors [15,25] are factors which hamper delivery of IPTp.…”

Low coverage of intermittent preventive treatment and insecticide-treated nets for control of malaria during pregnancy in sub-Saharan Africa — what needs to be done?

“…Another recent analysis recommends improving the quality of ANC services, including health provider adherence to national policy guidelines and improvements in supplies and logistics. 5 However, the current analysis does not show a correlation between ANC visits and IPTp coverage, 1 so will improvements in ANC service delivery necessarily increase coverage? An alternative option is to consider a greater role for community-based strategies that employ identification of all pregnant women in communities and use community-based agents like trained traditional birth attendants and organizations such as Safe Motherhood Action Groups to deliver IPTp to women without good access to health centers delivering antenatal care.…”

Mobiliser des représentations ethnoculturelles pour expliquer les disparités d’accès aux soins de santé au Burkina Faso

“…Les utilisatrices Peul, Songhaï, Bella et Dogon des services de santé -l' « Autre » -sont alors stigmatisées et blâmées, ce qui n'est pas nouveau en santé maternelle 2,33,34 . Dans ces études, les professionnels de la santé mettent en évidence « l'ignorance », « l'illettrisme » ou encore l'attachement des populations à des pratiques culturelles traditionnelles pour expliquer les disparités sur les indicateurs d'utilisation des services de santé 6,9,22 .…”