183314 Community-Clinic Collaboration to Control Malaria during Pregnancy in Nigeria

Wednesday, October 29, 2008

William R. Brieger, MPH, CHES, DrPH , Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Barbara Rawlins, MPH , JHPIEGO (affliated with Johns Hopkins University), Baltimore, MD
Gbenga Ishola, PhD , Nigeria Country Office, Jhpiego, Johns Hopkins University, Abuja, Nigeria
Rebecca S. Dineen, MS , Maternal and Child Health, Baltimore City Health Department, Baltimore, MD
Joseph Okeibunor , Department of Sociology, University of Nigeria Nsukka, Nsukka, Nigeria
Bright C. Orji, MPH , Jhpiego, Johns Hopkins University, Baltimore, MD
Emmanuel Otolorin, FRCOG , JHPIEGO (affliated with Johns Hopkins University), Baltimore, MD
Malaria in pregnancy (MIP) not only threatens the health and lives of pregnant women in Africa, it also leads to low birthweight and threatens child survival. Akwa Ibom State in Nigeria not only has year round transmission of malaria but also low utilization of public health services, especially antenatal care, that could prevent MIP. With Support from the ExxonMobil Foundation, JHPIEGO (an affiliate of the Johns Hopkins University) is undertaking a proof of concept intervention to strengthen MIP control services in Akwa Ibom State using a two pronged approach: 1) improving the quality of ANC services and 2) borrowing a leaf from onchocerciasis control activities and enlisting communities to support volunteer community directed distributors (CDDs) for malaria. Formative research in clinics and communities in both intervention and control local government areas revealed low levels of utilization of intermittent preventive treatment and insecticide treated nets by pregnant, and the reasons for these problems. The findings were used for advocacy with state and national stakeholders to leverage malaria commodities and to reach a consensus on community involvement in malaria commodity distribution. A team of core trainers has been developed at the State level. They in turn have trained front line health staff in both quality improvement (e.g. maintaining stocks of essential malaria commodities) as well as outreach to mobilize communities and train over 100 CDDs. Community and clinic monitoring results for the first year of intervention address both achievements and challenges of this approach.

Learning Objectives:
By the end of the presentation participants will ... 1. Outline steps in formative research to plan community-clinic collaboration in malaria in pregnancy (MIP) control 2. Describe key factors that influence uptake of MIP interventions in rural Nigeria 3. Explain how the community directed intervention approach can be applied to MIP control 4. List key performance standards that will improve MIP service quality and attract community members to antenatal clinics to receive these services

Keywords: Safe Mother Program, Community Collaboration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Principal Investigator of project
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.