Pouytenga, Burkina Faso – With every pregnancy, Adissa Silga traveled to the local health clinic for antenatal care. She wanted to protect herself and her unborn child against malaria, a disease endemic to this rural area about a two-hour drive from the capital, Ouagadougou. But the chloroquine pills she took in the past made her ill. She resisted taking them, which left her at risk and later sick from malaria. During her fifth pregnancy, however, Mrs. Silga benefited from an improved prevention regimen to help keep her pregnancy malaria-free, thanks to the U.S. Agency for International Development’s flagship Maternal and Child Health Integrated Program (MCHIP).
In Burkina Faso, MCHIP supports the National Malaria Control Program in building national, regional and district-level capacities and strengthening health systems to accelerate an expansion of services to prevent and control malaria. Program activities place an emphasis on pregnant women and children under five, who bear the heaviest burden of malaria.
About three million cases of malaria are reported annually among a population of approximately 15 million people in Burkina Faso. Malaria accounts for about 35 percent of all outpatient consultations, 41 percent of all hospitalizations and 38 percent of all deaths nationwide. Pregnant women like Mrs. Silga and children under five are most vulnerable to malaria. Each year, approximately 750,000 women will become pregnant in Burkina Faso and are at risk of malaria, which leads to higher rates of maternal anemia and low birth weight babies.
To reach the largest number of pregnant women with proven approaches for reducing the dangers of malaria in pregnancy, MCHIP focuses on in-service training for health care providers who see women during regular antenatal care (ANC) visits. Since the program started in Burkina Faso in 2009, MCHIP has trained 1,035 health care providers from 17 districts in malaria in pregnancy. Providers are trained in prevention through use of insecticide-treated bed nets and intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine pyrimethamine (SP), an effective anti-malarial medication provided during routine antenatal care in the second and third trimesters of pregnancy. Providers are also trained to diagnose malaria using rapid diagnostic tests and to promptly treat pregnant women who test positive. By September 2011, MCHIP will have trained 1,260 providers with in-service training to prevent and treat malaria in pregnant women.
Mrs. Silga’s experience is not uncommon in the area of Pouytenga, where MCHIP began working with local health providers in October 2010. During a December visit to the health clinic, she shared with MCHIP staff her experiences with malaria during her pregnancy.
“Whenever I am pregnant, I go to the health center for antenatal care so that I can receive advice and benefit from the available medicines in order to prevent diseases, especially malaria and anemia,” said Mrs. Silga. “During my previous pregnancies, I had to take chloroquine, which meant swallowing three tablets weekly, and continue that treatment for up to six weeks after delivery. This type of treatment was very hard for me because I often forgot to take my tablets. Sometimes I avoided taking them because of side effects such as dizziness and itchiness and therefore I often contracted malaria and had to stay in the health center for care. Pregnancies were very hard for me.
“Now, however, when you go to the health center for antenatal care, the providers will give you a different medicine to prevent malaria, which is better,” she said, referring to sulfadoxine pyrimethamine (SP). “I only need two doses during my pregnancy. This is easier and more comfortable for me and my family. Since I receive this treatment at the health center during my ANC visits, I cannot forget to take them. I can tell you that I feel better and have had neither fever nor malaria during my pregnancy till now.”
Mrs. Silga was appreciative of the improved health services facilitated through MCHIP. She had a word of advice for other young women: “I would like to encourage each pregnant woman to attend health facilities and benefit from the malaria prevention medicines (intermittent preventive treatment in pregnancy with sulfadoxine pyrimethamine) so that their pregnancy will be safe and they will have healthy babies.”