Increasing access to preventive malaria treatment in pregnancy

2022
Elaine Roman, Project Director - Transforming IPT for Optimal Pregnancy (TIPTOP)

1. What is the goal of the TIPTOP pilot project?

We aim to build evidence for intermittent preventive treatment in pregnancy delivered by community health workers (C-IPTp) so that WHO and countries can review and potentially adopt C-IPTp as a delivery mechanism as part of malaria in pregnancy programming, helping to achieve higher coverage of interventions globally. We also aim to set the stage for scale-up across the countries we target and with influence across sub-Saharan Africa.

2. How does the project break down barriers between pregnant women and the malaria medicines they need? 

TIPTOP was designed as a ‘no missed opportunities approach’ so that eligible pregnant women have access to IPTp with quality-assured (sulfadoxine-pyrimethamine) SP in the communities in which they live as well as at antenatal care clinics. To gain the trust of pregnant women, their families and the broader community, we worked with health workers who were selected by the community, along with local organizations. Pregnant women were counselled through CHWs and messaging about ANC, whilst malaria prevention, including IPTp, was reinforced through civil society organization platforms and other communication channels.

3. How will the evidence generated through this project be used?

The WHO will assess the data to determine whether it can be used to update its implementation recommendations (the ‘how to’). Countries will apply the learning to expand and scale up C-IPTp as well as introduce C-IPTp in countries where it has not yet been started.

4. What key challenges do you face?

The first challenge we face is keeping our CHWs and volunteers motivated. We also have the task of maintaining strong data systems that link community and facility-level monitoring. Outside of TIPTOP (since we supplied the drug), but across sub-Saharan Africa, we face the challenge of availability of quality-assured SP at antenatal care clinics. With continued country and partner commitment, I believe these barriers can be overcome.

5. What has it been like to work with MMV on this project? 

While MMV’s scope in the TIPTOP project was specific to the drug, we have (from the conceptualization phase) worked hand in hand to design, problem solve and meet the needs of the countries we support. It has been a true privilege to work with MMV.