Changing the policy for intermittent preventive treatment with sulfadoxine-pyrimethamine during pregnancy in Malawi

The intermittent prevention treatment of malaria during pregnancy policy and the contribution of research and stakeholders

Abstract

In 1993, Malawi was the first country to adopt intermittent prevention treatment of malaria during pregnancy (IPTp) using a malaria medication sold under the brand name Fansidar, and updated the policy in 2013. Later, the World Health Organization recommended the use of artemisinin-based combination therapy for uncomplicated malaria, due to the growing resistance of the malaria parasite to Fansidar treatment.

This case study examines the IPTp policy updating process and the contribution of research and key stakeholders to the process. The investigators systematically reviewed documents and evidence published from 1993 to 2012, in addition to conducting key informant interviews. 2 published studies from Malawi were instrumental in the WHO policy recommendation, which in turn led to the updating of the national policies. The updated policy on IPTp indicates that it is better to give more than two Fansidar doses, as informed by research, than two doses, because of the resistance of the malaria parasite and the absence of replacement drugs worldwide for IPTp. The investigators agree that the WHO recommendations facilitated the smooth policy change, driven by motivated local leaders and technical and financial support from development partners. The findings support the development of a malaria research-to-policy framework in Malawi.

This work was carried out by a International Centre of Insect Physiology and Ecology (icipe) researcher in the Malaria Programme, which is supported by core funding from the UK Department for International Development.

Citation

Mwendera C., de Jager C., Longwe H., Phiri K., Hongoro C. and Mutero C.M. (2017) Changing the policy for intermittent preventive treatment with sulfadoxine-pyrimethamine during pregnancy in Malawi. Malaria Journal 16, 84. doi: 10.1186/s12936-12017-11736-12939.

Changing the policy for intermittent preventive treatment with sulfadoxine-pyrimethamine during pregnancy in Malawi

Published 28 February 2017