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World Malaria Day 2017: Impact of Malaria in Pregnancy

There is an African Proverb which says, "If you think you're too small to make a difference, you haven't spent a night with a mosquito." These small creatures can make your night very unbearable with their noise and bites. You spend your whole night tossing and turning fighting off their bites and you try to cover your head with a pillow to cut out the noise they make. They are a nuisance!!

But it’s not only the noise and the bites that are annoying and terrifying to the people bitten by a mosquito. But it is the disease caused by mosquito bite. People fear malaria in this country as it is one of the biggest killers. According to WHO Country Health Profiles 2012-Malawi, malaria is ranked as the third cause of death in the country, standing at 6%. It is also ranked in the top five killers in Africa. The slightest sign of a fever causes one to rush to the nearest health facility to go for a malaria test. No one wants to take any chances with a mosquito bite or even a slight fever.

As the world today commemorates World Malaria Day, MamaYe Malawi wants to focus on the theme “Impact of Malaria on Pregnancy”. Pregnant women are at a high risk of dying from complications of severe malaria. As such, pregnant women are carefully monitored and encouraged to visit antenatal clinics after the first trimester for regular check-ups. Malaria is a cause of miscarriage, premature delivery, stillbirth and severe maternal anaemia, and is responsible for about one third of preventable low-birth-weight babies. For pregnant women living in moderate-to-high transmission areas, WHO recommends intermittent preventive treatment at each scheduled antenatal visit after the first trimester.

In order to reduce the number of deaths resulting from malaria and/or anaemia, the government of Malawi together with its development partners have put in place strategies to prevent this preventable disease. One of the preventative strategies is to encourage people to be donating blood. The country currently needs about 172,000 units of blood each year, of which 66% goes to mothers and children. Institutions such as Malawi Blood Transfusion Services (MBTS) have been working together with partners such as MamaYe Malawi to mobilize communities to donate blood by going to schools and various institutions.  

A primary intervention which the government of Malawi and its partners have been advocating for is for all households in the country to sleep under a mosquito net or an insecticide-treated net (ITN). According to the recent 2015-2016 DHS, 57 percent of househods possess at least one ITN.

Children under the age of 5 and pregnant women are most susceptible to malaria, hence the government of Malawi has been pleading with its citizens to make sure that mothers and children under the age of 5 sleep under an ITN. 

As much as the use of ITN has been effective in reducing malaria cases, there has been a continued abuse on how the nets are used in the communities. There have been a number of incidences where people have been using the ITNs as perimeter fences around their vegetable gardens or used as finishing nets. Although efforts are being made to advocate for the proper use of the ITNs through various media houses and other interventions, behaviour change is still a long way to go to make people understand the intended use of the ITNs as a prevention for Malaria. 

Malaria also has a negative impact in pregnancy which causes birth defects and stillbirths. According to the 2016 Lancet Series on Ending Preventable Stillbirths, an estimated 2.6 million stillbirths occurred in 2015 of which sub-Saharan African had the highest stillbirth rate (28.7 stillbirth per 1,000 total births).

In sub-Saharan Africa, 20% of stillbirths are associated with malaria, and as we know, malaria can be prevented and treated. Another factor in reducing preventable stillbirths is improving access to high quality health care where health facilities have adequate drugs and skilled health personnel.

In conclusion, Malawi has the capacity to reduce the incidence (new cases) of malaria in pregnancy as evidenced in how the country has been able to implement its interventions in malaria integrated programs. MamaYe will continue to advocate for safe and healthy pregnancy for women and make pregnancy a joy for mothers free and safe from malaria.

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