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The second in a series of 2008 World Malaria Day updates about Jhpiego's efforts to protect people from malaria. Jhpiego reaches across borders to fight a disease that has no borders.
Innovating to save lives from malaria in Akwa Ibom
April 2008
 Community members share their concerns about malaria at a community meeting in Akwa Ibom State, Nigeria. Each year, 30 million pregnancies are threatened by malaria in
endemic countries throughout Africa. Of these, one of the hardest hit is
Nigeria, where the disease accounts for 11% of maternal mortality and 12-30% of
mortality in children under five years
old.
In Akwa Ibom State, Nigeria few pregnant women utilize formal antenatal care services within the State's public health services. They are not benefiting from the country's
malaria in pregnancy (MIP) control efforts because of problems with health care service quality and accessibility. When surveyed, 65% of recently pregnant women in Akwa Ibom State responded that they attended some form of antenatal care services and only 8% reported taking intermittent preventive treatment (IPTp) in the two recommended doses. In the State's health care facilities few staff have been trained in MIP and many facilities do not have IPTp for malaria with sulfadoxine pyrimethamine (SP) in stock.
It is interesting to note, however, that when members of the community were asked, they were very aware of the problems malaria can cause in pregnant women and
said they would be supportive of MIP services.
To work to address these gaps in services, Jhpiego is in the process of testing a two-pronged approach that involves the community in service delivery and strengthens the quality of local health care services. In a project supported by the ExxonMobil Foundation, volunteers are being trained to deliver IPTp with SP for malaria as well as insecticide-treated bednets to pregnant women in their own kindreds (clans) in four of the 31 local government areas of Akwa Ibom State.
In the year since the project's inception, Jhpiego has established the framework for the program's implementation including a baseline assessment, recruitment of a local partner organization (Community Partners for Development) and the development of a core training team from the State Ministry of Health (SMOH).
Thus far, a team of 18 core State trainers has trained 25 health providers at the local government area level who, in turn, trained 107 health care providers from front-line health facilities on basic malaria control and quality improvement standards. Core trainers are now working with front-line health facility staff on community mobilization and the training of over 600 volunteers to provide initial IPTp, bed nets and referral for antenatal care follow-up.
The challenge now is to leverage basic malaria commodities from the World Bank-supported Malaria Booster program in the State for use by the volunteers and the front-line health facility staff. As the project progresses, record keeping by the volunteers and facility staff will contribute to overall monitoring of the approach’s impact. If successful, this will be the first such MIP intervention that creates a partnership with the community and the health services.
About Jhpiego
For 35 years, Jhpiego, (pronounced "ja-pie-go"), has empowered front-line health
workers by designing and implementing simple, low-cost, hands-on solutions that
strengthen the delivery of health care services, following the
household-to-hospital continuum of care. We partner with community- to
national-level organizations to build sustainable, local capacity through
advocacy, policy and guidelines development, and quality and performance
improvement approaches.
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