This study evaluates the effectiveness of community delivery of sulfadoxine-pyrimetamine (SP) for intermittent preventive treatment of malaria in pregnancy (IPTp) in increasing the coverage of IPTp among pregnant women in selected districts in Democratic Republic of Congo (DRC), Madagascar, Mozambique and Nigeria, compared to comparison districts where SP for IPTp is distributed as usual in facilities through routine antenatal care (ANC).
The specific objectives of this study are to determine the change in the following indicators during the course of the TIPTOP project: 1) Proportion of women who have had a pregnancy that ended in the past 12 months and have received 1 or more, 2 or more and 3 or more doses of IPTp-SP; proportion of women with pregnancy in the past 12 months who attended ANC clinics at least once, and who attended at least four times; proportion of pregnant women attending the first ANC visit before or at week 14; proportion of women who have had a pregnancy that ended in the past 12 months who know about the IPTp service provided by CHWs; and acceptability of C-IPTp for community delivery of IPTp (note: results will be disaggregated by provider type, age, gravidity and distance from facility). To assess these changes, the study will implement structured household surveys targeting potential beneficiaries of the project (pregnant women) in the intervention and comparison areas, implemented at three time points: baseline, mid- and end-points. In each country an initial implementation area (Phase I) and two expansion areas (Phase II) have been selected for the project. This study will establish if community deliver of IPTp is effective and feasible and whether it influences antenatal care service coverage rates. It is expected that the study will provide information to scale up the approach the 4 study countries for the prevention of malaria in pregnancy. This information is also meant to inform global guidelines on community IPTp delivery and may also be used by other countries.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
10,602
SP is distributed to eligible pregnant women by trained Community Health Workers (CHWs) at community level. Demand creation activities are implemented within the community as well.
Kenge District, Community Setting
Kenge, Kwango, Democratic Republic of the Congo
Bulungu District, Community Setting
Bulungu, Kwilu, Democratic Republic of the Congo
Community Setting
Kunda, Maniema Province, Democratic Republic of the Congo
IPTp3 Coverage
Proportion of women who had a pregnancy ending in the past 12 months and have received three or more doses of IPTp-SP
Time frame: 1 year
IPTp1 Coverage
Proportion of women who have had a pregnancy that ended in the past 12 months and have received one or more doses of IPTp-SP
Time frame: 1 year
ANC 4 coverage
• Proportion of women who have had a pregnancy that ended in the past 12 months and have attended ANC clinics four times
Time frame: 1 year
ANC 1 Coverage
Proportion of women who have had a pregnancy that ended in the past 12 months and have attended ANC clinics at least once
Time frame: 1 year
Early ANC Coverage
Proportion of pregnant women attending the first ANC visit before or at week 14
Time frame: 1 year
C-IPTp Knowledge
Proportion of women who have had a pregnancy that ended in the past 12 months who know about the IPTp service provided by CHWs
Time frame: 1 year
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Mananjary District, Community Setting
Mananjary, Fianarantsoa, Madagascar
Community Setting
Toliara, Fianarantsoa, Madagascar
Community Setting
Vohipeno, Vatovavy-Fitovinany, Madagascar
Meconta District, Community Setting
Meconta, Nampula, Mozambique
Community Setting
Murrupula, Nampula, Mozambique
Nhamatanda District, Community Setting
Nhamatanda, Sofala, Mozambique
Community Setting
Ohaukwu District, Ebonyi State, Nigeria
...and 2 more locations