Increasing malaria prevention in pregnant women in south Sudan

BAckground: Administration of two doses of intermittent preventive treatment (IPT) with sulfadoxine/pyramethamin (SP) and consistent use of LLINs reduces pregnancy complications and neonatal deaths from malaria. In 2010, a household survey in South Sudan showed that only 22.7% of pregnant women received two doses of SP. Methods: The second phase of the Sudan Health Transformation Project (SHTP II) focused on prevention of malaria in pregnancy. By outreach to pregnant women to increase attendance at ANC services, training of maternal health provider staff in IPT, and provision of medications and commodities with minimal stockouts, the SHTP II aimed to increase the number of pregnant women who received IPT 2. In addition, distribution of LLINs during ANC and under 5 services will increase sleeping under an LLIN. Results: Suring the three years of the SHTP II, IPT2 visits increased 229% and coverage of IPT 2 increased from from 29% to to 53%. ANC 1 increased from a basleine of 53% to 83% of PW, and ANC 4 increased from 23% to 49% of PW. Conclusion: Significant increases in utilization of ANC 1 And ANC 4 services improved both IPT 2 and LLIN distribution and use, contributing to overall improvements in maternal and newborn care. Increasing access to malaria in pregnancy prevention efforts by integrating community awarenes, outreach and service delivery is possible even in the challenging fragile state of South Sudan.