Health Goal: 1. Reduce malaria mortality by one-third from 2015 levels in PMI-supported countries, achieving a greater than 80 percent reduction from PMI’s original 2000 baseline levels. 2. Reduce malaria morbidity in PMI-supported countries by 40 percent from 2015 levels. | ||
Pregnant women complete a full course of IPTp Indicator: Percentage of women age 15-49 with a live birth in the two years preceding the survey who during the pregnancy took 3 or more doses of SP/Fansidar, with at least one dose during an antenatal care visit
Indicator: Percentage of women age 15-49 with a live birth in the two years preceding the survey who during the pregnancy took 2 or more doses of SP/Fansidar, with at least one dose during an antenatal care visit |
Behavior Analysis |
Strategy | ||
---|---|---|---|
BEHAVIOR AND STEPSWhat steps are needed to practice this behavior?Pregnant women complete a full course of IPTp
|
FACTORSWhat factors may prevent or support practice of this behavior?StructuralAccessibility: Pregnant women cannot access SP because the SP or related commodities are unavailable. Service Provider Competencies: Pregnant women do not receive SP at each visit because providers do not have the proper technical information to adhere to national MIP guidelines. SocialFamily and Community Support: Pregnant women do not seek SP because it is not promoted or encouraged by community-based community health volunteers or agents. InternalAttitudes and Beliefs: Pregnant women refuse SP because they fear the side effects. Attitudes and Beliefs: Pregnant women do not adhere to provider instructions because they do not understand the difference between drug-based prevention and treatment. Knowledge: Pregnant women do not obtain SP or adhere to provider’s instructions because they are unaware of the benefits of SP for themselves and their unborn children. |
SUPPORTING ACTORS AND ACTIONSWho must support the practice of this behavior, and what actions must they take?InstitutionalPolicymakers: Incorporate IPTp into broader reproductive health programs in collaboration with MIP point of contact and reproductive health staff. Managers: Conduct regular supportive supervisory visits with facility-based service providers to ensure proper administration of and counseling for IPTp. Managers: Seek innovative ways to provide client-friendly services closer and more convenient to the client. Logistics Personnel: Procure sufficient stock of SP or other IPTp commodity supplies. Providers: Counsel about protective benefits, timing and dosing of IPTp to all pregnant women and their partners. Providers: Administer SP appropriately during ANC visits. CommunityCommunity Leaders: Create or support structures that promote social accountability to encourage community-based service providers to promote the benefits of IPTp as part of ANC services. Community and Religious Leaders: Engage men and male heads of households to support the decision of pregnant women to seek ANC especially in the absence of community-based service provider support. |
POSSIBLE PROGRAM STRATEGIESWhat strategies will best focus our efforts based on this analysis?Strategy requires Communication Support Enabling EnvironmentPartnerships and Networks: Encourage delivery of ANC and IPTp in non-formal settings, such as through NGOs and by community health workers directly in the community to ensure that ANC is accessible to all women. Policies and Governance: Integrate IPTp into reproductive health programs to ensure that all women accessing these services receive IPTp. Policies and Governance: Create or leverage the power and influence of existing community leaders and members to advocate for accountability at health facilities. Systems, Products and ServicesSupply Chain: Strengthen commodities and supply chain for Fansidar/SP or IPTp protocol at all levels to ensure adequate stock for the recommended minimum number of doses per expected pregnant woman. Quality Improvement: Disseminate to providers clear IPTp guidelines and information to use in counseling women on benefits to ensure that all women are receiving recommended IPTp during ANC. Quality Improvement: Expand and promote services offered during ANC to increase women’s perceived value of IPTp. Quality Improvement: Equip health workers with relevant, locally tailored behavior-centered job aids to provide better IPTp services to women. Demand and UseCommunication: Use appropriate communication approaches to promote value of preventative services to mother and unborn child. Communication: Exploit direct-to-consumer digital tools, such as mobile technologies, interactive voice response (IVR), etc. to reach women directly to convey benefits of and value for IPTp as part of routine ANC visits. |