Number/percent of women who were treated for malaria during their most recent pregnancy
This indicator measures the number or percent of pregnant women who received malaria treatment during a specified time period (i.e. past one, six or 12 months).
As a percent, this indicator is calculated with facility data as:
(Number of pregnant women who were treated for malaria during specified time period / Total number of pregnant women attending antenatal care during specified time period) x 100
Antenatal records of number of clients seen and number treated for malaria
Health facility records
This indicator measures not only access to malaria in pregnancy (MIP) services, but also service provider adherence to MIP guidelines. Screening for signs and symptoms of malaria should be a routine part of antenatal care. All pregnant women in areas of both high and low transmission need prompt access to treatment for malaria if they become ill, although many pregnant women with malarial infections in areas of high transmission have some immunity, and therefore do not exhibit symptoms of the disease which leads to many cases going undiagnosed (JHPIEGO, 2002). In 2010 WHO recommended that all patients suspected of malaria receive parasitological confirmation either by microscopy or rapid diagnostic test before treatment is started. Treatment based on clinical diagnosis – that is, presumptively, based on presentation of the signs and symptoms of the disease – should be considered only when parasitological confirmation is not accessible (World Health Organization 2010).
In order to be effective, a drug treatment regimen should clear malaria parasites from the mother’s blood and the placenta. A wide range of drugs, as well as oxygen and blood transfusions, can be used to treat problems related to malaria, such as convulsions, anemia, and respiratory difficulties. Research into non-drug strategies have indicated that the use of micronutrient supplements (i.e. iron and folate) and other substances can mitigate some of the effects of malaria in pregnancy, and may help support the efficacy of drug treatment.
HIV-positive women have compromised immune systems and are therefore less able to resist infection with malaria parasites than their HIV-negative peers. HIV positive women require more extensive care, and some antimalarial drug regimens may be rendered less effective in the presence of HIV. One way to address this problem is to adjust courses of treatment (Malaria in Pregnancy Network, 2003).
Antenatal clinic data might be incomplete and not reflect the true situation in settings where a substantial number of women do not access antenatal care at all or have antenatal care at private clinics. Private clinics should be encouraged to follow national guidelines in treating MIP and maintain appropriate records.
Also, the indicator does not provide any information on the quality of the treatment services provided, rather it is a better measure of access to MIP services.
access, newborn (NB), malaria, safe motherhood (SM)
The unequal balance of power between men and women and inequitable access to health care and financial resources as a result of gender and other social inequalities paves the way for women’s vulnerability to malaria and other infectious diseases.
It also affects women’s ability to respond appropriately and access prevention and treatment efforts where available (Roll Back Malaria Partnership, 2006).
JHPIEGO. Preventing and Treating Malaria during Pregnancy. Maternal and Neonatal Health Best Practices, 2002.
Malaria and Pregnancy Network. Approaches to Malaria and Pregnancy. AED, SARA Project, 2003.
Roll Back Malaria Partnership. A Guide to Gender and Malaria Resources. 2006.
WHO. Guidelines for the Treatment of Malaria, Second Edition. 2010. Geneva.
Roll Back Malaria Partnership. Guidelines for Core Population-Based Indicators. MEASURE Evaluation: Calverton, MD. 2011.