PROJECT SUMMARY:
Malaria in pregnancy remains a major public health concern that is associated with maternal and fetal adverse
events and is the leading cause of preventable maternal deaths in sub-Saharan Africa. Despite the proven
efficacy of Sulphadoxine-pyrimethamine (intermittent prophylaxis treatment of malaria_ IPTp_SP) and
cotrimoxazole as prophylaxis treatment of malaria in HIV negative and HIV positive pregnant women
respectively, adherence to these medications remains unacceptable in Uganda especially in Kampala.
Sub-optimal adherence to malaria preventive therapy is reported to be due to lack of education or ignorance
about these interventions among pregnant women, and the lack of exposure to malaria prevention messages to
stimulate behavioral change. Additionally, due to overpopulation in Kampala and the persistent shortage of
health workers like in many other low resource settings, health workers often don’t have adequate time to
sufficiently educate pregnant women about all Antenatal care procedures including the IPTp-SP dosing schedule
for HIV negative pregnant women and re initiation to cotrimoxazole for HIV positive pregnant women. To address
this critical knowledge gap on adequate malaria preventive therapy utilization among pregnant women, we
propose a combined implementation and dissemination interventional approach. This will primarily involve the
development of the intervention named “PreVent” (PREvention of malaria in pregnancy using Video-based
Education to eNhance opTimal malaria preventive therapy knowledge and uptake).
In this R03, we will develop, tailor, and refine the video to address malaria preventive therapy knowledge deficits
in a client-centered manner. The PreVent intervention will involve a 10 min video to educate pregnant women
about current IPTp-SP and cotrimoxazole recommendations during ANC followed by a 5 min question and
answer session with a health worker. We will qualitatively assess the PreVent intervention for feasibility,
acceptability, and appropriateness using a pilot study in an urban public health facility. The obtained data will be
used to prepare for an R21 grant in which we will rigorously evaluate the effectiveness of the intervention in
increasing optimal IPTp-SP and cotrimoxazole uptake. Ultimately, this and progressive studies will result in the
development of a cost-effective, evidence-based, and scalable intervention that will eventually reduce malaria-
related maternal and neonatal adverse outcomes.
