The provider’s checklist to improve pregnant women coverage by intermittent preventive malaria treatment in Mali: a pilot implementation study

Abstract

Background Intermittent preventive treatment of malaria in pregnancy (IPTp) is a comprehensive treatment protocol of anti-malarial drugs administered to pregnant women to prevent malaria, started at the fourth pregnancy month, with at least three doses of sulfadoxine–pyrimethamine (SP), taken as directly observed treatment (DOT) every 30 days at intervals until childbirth, in combination with other preventive measures. This paper introduces feasibility and adoption concepts as implementation research outcomes (IRO), allowing after a defined intervention, to assess the coverage improvement by IPTp for women attending a reference district hospital in Mali. Specifically, the purpose is to evaluate the feasibility of a reminder tool (provider checklist) to enhance pregnant women’s adoption of information about IPTp-SP uptake as immediate and sustained women practices. Methods The implementation strategy used a reminder checklist about malaria knowledge and the recommended preventive tools. Then, the checklist feasibility was assessed during routine practices with the adoption-level about pregnant women’ knowledge. Quantitative data were collected through a questionnaire distributed to a non-probability purposive sampling targeting 200 pregnant women divided into two groups before and after the checklist intervention. In contrast, the qualitative data were based on in-depth face-to-face gynaecologists’ interviews. Results Both the IROs (feasibility and adoption) were satisfactory. The gynaecologists agreed to the use of this checklist during routine practice with a recommendation to generalize it to other health providers. After a gynaecologist visit, a significant increase of the adoption-level about prior knowledge and preventive tools was noticed. A total of 83% of participants were not knowledgeable about malaria disease before checklist use versus 15% after. Similarly, coverage of women’s SP DOT rose from 0 to 59% after introducing the checklist and the IPTp-SP uptake after the visit was highly significant in the second group. The latter reached 95% of pregnant women with 4–8 months’ gestational age, that mostly respected all SP future visits as theoretically scheduled. Conclusions Generalizing such a checklist reminder will improve women’s knowledge about malaria prevention.

Micro-costing from healthcare professional’s perspective and acceptability of cutaneous leishmaniasis diagnostic tools in Morocco: A mixed-methods study

“…The perception of improving the quality of care for CL management in primary health centres supports HPs’ acceptability of the test and perceptions of its advantages, as seen with malaria RDTs in Ghana and Mali [ 16 , 40 ].…”

Systematic Review of Mixed Studies on Malaria in Pregnancy: Individual, Cultural and Socioeconomic Determinants of Its Treatment and Prevention

“…The criteria least applied were "adheres to the quality criteria of the methods involved" of the MMAT; bias controls and description of the type of study in STROBE; while in SRQR were the indication of the research paradigm, characteristics of the research and guarantees of reflexivity, type of study, and techniques to enhance trustworthiness and credibility of the data (Figure 2B). The largest proportion of studies did not indicated the type of mixed study carried out (they only stated the use of quantitative and qualitative techniques); a mixed convergent study was found [43], one explanatory sequential QUAN-Qual [45] and one exploratory QUAN-Qual [44]. Only two studies made explicit the qualitative approach used [29,37].…”

“…The integration of qualitative and quantitative evidence was accomplished in the following ways: the qualitative results were used to create a survey, some findings of the The largest proportion of studies did not indicated the type of mixed study carried out (they only stated the use of quantitative and qualitative techniques); a mixed convergent study was found [43], one explanatory sequential QUAN-Qual [45] and one exploratory QUAN-Qual [44]. Only two studies made explicit the qualitative approach used [29,37].…”

“…The qualitative categories were: knowledge about malaria (caused by mosquito bites), attitude towards the use of ITN (agreeing that use ITN use helps to prevent malaria), not making effective use of ITN despite know its benefits Rassi [43] Intervention improve knowledge of SP-IPTp and coverage of three doses of SP-IPTp Intervention is a feasible, acceptable and cost-effective. The text messages served as reminders for those who had attended the classroom training and helped spread information to those who did not Doumbia [44] After a visit to the gynecologist increased the level of knowledge and preventive actions; 83% of participants were unaware of malaria before use of the checklist vs. 15% after. Supervised SP-IPTp coverage increased from 0 to 59% after the introduction of the checklist…”

“…Health workers have a good level of knowledge about this intervention, 88% know the SP-IPTp policy [32], 81% know the guidelines for its administration, and 83% knew that the guidelines recommend at least two doses [39]. The knowledge and use of SP-IPTp could be improved with simple interventions, as shown in the studies of Rassi [43] and Doumbia [44].…”