Human Resources Directorate, Health and Social Development Ministry, Bamako, Mali.
National Malaria Control Program Directorate, Health and Social Development Ministry, Bamako, Mali.
Malar J. 2021 Oct 16;20(1):402. doi: 10.1186/s12936-021-03940-7.
Intermittent preventive treatment of malaria in pregnancy (IPTp) is a comprehensive treatment protocol of anti-malarial drugs administered to pregnant women to prevent malaria, started at the fourth pregnancy month, with at least three doses of sulfadoxine-pyrimethamine (SP), taken as directly observed treatment (DOT) every 30 days at intervals until childbirth, in combination with other preventive measures. This paper introduces feasibility and adoption concepts as implementation research outcomes (IRO), allowing after a defined intervention, to assess the coverage improvement by IPTp for women attending a reference district hospital in Mali. Specifically, the purpose is to evaluate the feasibility of a reminder tool (provider checklist) to enhance pregnant women's adoption of information about IPTp-SP uptake as immediate and sustained women practices.
The implementation strategy used a reminder checklist about malaria knowledge and the recommended preventive tools. Then, the checklist feasibility was assessed during routine practices with the adoption-level about pregnant women' knowledge. Quantitative data were collected through a questionnaire distributed to a non-probability purposive sampling targeting 200 pregnant women divided into two groups before and after the checklist intervention. In contrast, the qualitative data were based on in-depth face-to-face gynaecologists' interviews.
Both the IROs (feasibility and adoption) were satisfactory. The gynaecologists agreed to the use of this checklist during routine practice with a recommendation to generalize it to other health providers. After a gynaecologist visit, a significant increase of the adoption-level about prior knowledge and preventive tools was noticed. A total of 83% of participants were not knowledgeable about malaria disease before checklist use versus 15% after. Similarly, coverage of women's SP DOT rose from 0 to 59% after introducing the checklist and the IPTp-SP uptake after the visit was highly significant in the second group. The latter reached 95% of pregnant women with 4-8 months' gestational age, that mostly respected all SP future visits as theoretically scheduled.
Generalizing such a checklist reminder will improve women's knowledge about malaria prevention.
孕妇间歇性预防治疗疟疾（IPTp）是一种向孕妇提供抗疟药物的综合治疗方案，以预防疟疾，从怀孕第四个月开始，至少给予三剂磺胺多辛-乙胺嘧啶（SP），并作为直接观察治疗（DOT）每 30 天一次，直至分娩，同时结合其他预防措施。本文介绍了可行性和采用概念作为实施研究结果（IRO），以便在规定的干预措施后，评估在马里一家参考地区医院就诊的妇女接受 IPTp 的覆盖率提高情况。具体而言，目的是评估提醒工具（提供者检查表）的可行性，以增强孕妇对接受磺胺多辛-乙胺嘧啶（SP）信息的采用，作为即时和持续的妇女实践。
实施策略采用了疟疾知识和推荐预防工具的提醒检查表。然后，在常规实践中评估了检查表的可行性，评估了孕妇对知识的采用水平。通过问卷调查收集了定量数据，该问卷针对非概率目的抽样，针对 200 名孕妇，分为干预前后两组。相比之下，定性数据基于对妇科医生的深入面对面访谈。
实施研究结果（IRO）的可行性和采用水平均令人满意。妇科医生同意在常规实践中使用这种检查表，并建议将其推广到其他卫生提供者。在妇科医生就诊后，对先前知识和预防工具的采用水平显著提高。在使用检查表之前，有 83%的参与者对疟疾疾病没有了解，而使用之后，这一比例为 15%。同样，在引入检查表后，妇女接受 SP 点滴治疗的覆盖率从 0 上升到 59%，在第二组中，就诊后接受磺胺多辛-乙胺嘧啶的比例非常显著。后者达到了 95%的孕妇，其中大多数孕妇在 4-8 个月的妊娠期内，按照理论上的预约，大多接受了所有的 SP 后续就诊。
推广这种检查表提醒将提高妇女对疟疾预防的认识。
