This practical guide is intended to help African countries implement and scale up programs to prevent and treat malaria in pregnancy. It was inspired by the WHO/AFRO Strategic Framework for Malaria Control during Pregnancy in the African Region, which presents a systematic approach to program implementation. This guide describes seven essential program components within that approach that are needed to put MIP policy into practice at the health care facility level. The guide also includes practical solutions to frequently seen problems as well as considerations for financing. The intended audience for this guide is policymakers, public health professionals and national malaria control and reproductive health program managers and health workers, as well as private, nongovernmental and faith-based organizations. Countries working at all levels of implementation – from start up to scale up – will find the guide beneficial since it draws on real country experiences, results and lessons learned.