Prevention (ITNs, MIP and SMC)

Prevention is critical in reducing morbidity and mortality due to malaria. Currently, there are several interventions for the prevention of malaria that are approved by WHO and supported by donors and the RBM partnership for scale up in endemic countries. These include the distribution and use of insecticide-treated nets (ITNs), indoor residual spraying (IRS), uptake of intermittent preventive treatment in pregnancy (IPTp), and seasonal malaria chemoprophylaxis (SMC). MSH’s work has improved systems and assisted NMCPs, districts, facilities and communities, via integrated health programs, to make ITNs available and ensure their use, to support improved services related to malaria in pregnancy (MIP), and to implement SMC campaigns.

Insecticide-Treated Nets (ITNS)

Insecticide-treated nets are the main tool that malaria-endemic countries have to prevent transmission. Ensuring that ITNs are available to everyone all the time and are used consistently is the major challenge these countries face.

MSH assists NMCPs and key partners to plan, organize, and execute national campaigns to distribute ITNs as well as communicate important messages about the need for beneficiaries to use their nets each night. MSH also improves distribution systems to ensure ITNs are available in health facilities for routine distribution to children and pregnant women. MSH is at the center of efforts to ensure gains in ITN coverage and use are sustained, and to increase coverage and use by training health workers to distribute nets to pregnant women attending antenatal care and to children coming for child immunization services, by supporting educational campaigns that teach households the importance of making sure that pregnant women and children use ITNs every night, and by expanding distribution channels to reach school children and the private sector.

Malaria In Pregnancy (MIP)

Malaria in pregnant women contributes to several negative outcomes including miscarriage, premature birth, labor complications, low birth-weight babies, anemia, and maternal and newborn death. In order to prevent MIP, antenatal care services dispense ITNs and IPTp. Based on WHO recommendations, ITNs are given to pregnant women at their first ANC visit, while IPTp is administered at each ANC visit, starting early in the second trimester, at one-month intervals, up to delivery, with a target of at least three doses administered over the course of a pregnancy. IPTp is composed of a treatment dose (three tablets) of sulfadoxine-pyrimethamine and administered by direct observation of an ANC attendant.

MSH works to mitigate the effects of MIP by supporting the integration of malaria prevention and treatment into existing maternal health programs, supporting NMCPs to roll out revised WHO guidelines, training health workers, raising awareness in communities, educating pregnant women, engaging the private sector, and developing strategies to reach pregnant women in remote or challenging peri-urban settings. To reinforce these efforts, MSH uses community-mobilization activities, develops and distributes job aids and educational materials, and utilizes quality assurance tools to assess and improve service standards.

As a leading expert in prevention of mother-to-child transmission (PMTCT) of HIV, MSH incorporates malaria coverage into its HIV programming. Our field teams provide ongoing support to ensure that malaria and HIV drugs are available for mothers and children.

Seasonal Malaria Chemoprophylaxis (SMC)

Malaria is one of the leading causes of mortality in children under the age of five. While ITNs are considered the main tool available to prevent malaria infections, many countries where malaria transmission is highly seasonal use SMC to prevent malaria illness and death. SMC is the intermittent administration of full treatment courses of an antimalarial medicine to children under the age of five years. WHO recommends the use of sulfadoxine-pyrimethamine + amodiaquine (AQ-SP) in these countries, all of which are located in the Sahel sub-region of Africa. Giving effective antimalarial treatment at monthly intervals during this period (usually 3 to 4 months) has been shown to be 75% protective against uncomplicated and severe malaria in children under the age of five. SMC is cost-effective and safe and can be administered by community-health workers.

MSH supports SMC in the eight target countries of Burkina Faso, Chad, Gambia, Guinea, Mali, Niger, Nigeria, and Senegal, by optimizing the supply chain and managing the costing plan, to ensure a steady and sufficient supply of AQ-SP is available during these campaigns.