Jhpiego - What We Do - Malaria Prevention and Treatment

Each year, as many as 500 million cases of malaria occur worldwide, leading to one million deaths, mostly in sub-saharan Africa. The vast majority of malaria deaths occur in Africa, especially in remote rural areas with poor access to health services.

Malaria is especially dangerous for pregnant women and their unborn children. In sub-saharan Africa, malaria infection is estimated to cause 400,000 cases of severe maternal anemia and 75,000–200,000 infant deaths annually. Maternal anemia contributes significantly to maternal mortality and causes an estimated 10,000 deaths per year.

Co-infections of malaria and HIV/AIDS—which are most common in sub-saharan Africa—have major health implications. HIV/AIDS increases the risk of infection with malaria and decreases response to standard anti-malarial treatment. Malaria also contributes to increased viral load among HIV-infected people.

The good news is that malaria can be prevented, reduced and managed with low-cost interventions.

What Is Jhpiego Doing?

Jhpiego's work in malaria focuses on interventions to prevent malaria in pregnancy and manage the disease in women who become sick. Our comprehensive approach supports the World Health Organization (WHO)'s three-pronged approach, which includes:

In areas of stable transmission, intermittent preventive treatment in pregnancy (IPTp) with an effective anti-malarial medication during routine antenatal care in the second and third trimesters of pregnancy, at least one month apart

In areas of stable and unstable transmission, the use of insecticide-treated bed nets

In areas of unstable transmission, rapid treatment for pregnant women showing signs of malaria

Statistics show that women attending focused antenatal care* have a much greater likelihood of remaining free of malaria and delivering a healthy baby. Jhpiego's programs in Africa promote integrating malaria in pregnancy services as part of routine antenatal care.

Global Initiatives

Partnerships are critical to controlling malaria in Africa. Jhpiego participates in international initiatives, as well as regional malaria coalitions throughout sub-saharan Africa. Jhpiego assists countries with revising malaria policies, developing training materials, strengthening pre-service education and in-service training, improving community awareness, improving services through quality assurance and establishing monitoring and evaluation systems—all key to building country-level expertise necessary to scale-up malaria programs.

Jhpiego was among the first recipients of U.S. funding from the President's Malaria Initiative (PMI), and has since expanded its PMI work into multiple countries.

Jhpiego is also an active participant in WHO's Roll Back Malaria (RBM) Partnership, which began in 1998 to coordinate the fight against the disease worldwide. The Jhpiego/ACCESS Program has taken a global leadership role in spearheading the work of RBM's Malaria in Pregnancy Working Group.

ACCESS provides technical assistance to African countries that have Global Fund grants for malaria, specifically to overcome their bottlenecks to program implementation.

ACCESS was also a part of the Malaria Action Coalition (MAC), a four-year partnership sponsored by the U.S. Agency for International Development (USAID). Through this partnership, ACCESS provided technical assistance to prevent and control malaria in pregnancy by strengthening the platform of antenatal care services.

Jhpiego also works closely with regional malaria networks throughout sub-saharan Africa. Jhpiego helped to launch both the Malaria in Pregnancy East and Southern Africa (MIPESA) Coalition and the West African Network for the Prevention and Treatment of Malaria in Pregnancy (RAOPAG). Both are country-driven networks fostering the regional exchange of evidence-based best practices and lessons learned in order to accelerate the prevention and control of malaria in pregnancy at the country level. Through these regional bodies, Jhpiego has affected changes in malaria policy and assisted in the regional capacity development of trainers, providers and managers to build country-level expertise.

Country Programs

Jhpiego works in 12 African countries with endemic malaria. Highlights of our current work with malaria in pregnancy include:

ANGOLA: Under a grant from the ExxonMobil Foundation, Jhpiego is pioneering an improved monitoring and evaluation system for malaria in pregnancy programming with the Ministry of Health.

BENIN: Jhpiego supports the Benin-based RAOPAG, which works to change policies regarding treatment for malaria in pregnancy throughout the region.

BURKINA FASO: Jhpiego collaborated with the Centers for Disease Control and Prevention and the Burkinabè National Center for Research and Training in Malaria on a pilot program to introduce IPTp with sulfadoxine-pyrimethamine (SP), which prompted the adoption of IPTp/SP as national policy in Burkina Faso. Jhpiego also supported the training of providers in focused antenatal care and malaria in pregnancy, reaching 80% of facilities in the Centre-Ouest region.

GHANA: Jhpiego adapted training materials and trained supervisors and trainers in focused antenatal care and malaria in pregnancy; these individuals in turn trained providers in other regions of the country.

KENYA: Jhpiego is partnering with the Kenyan government to support the dissemination of the artemisinin-based combination therapy (ACT) regimen for case management of clinical malaria through a variety of training activities.

MADAGASCAR: Jhpiego collaborates with the Madagascar government and partners to scale up malaria in pregnancy services and assure quality service delivery through the development and implementation of malaria norms, protocols and clinical performance standards at the facility level and through provider training activities. Jhpiego has expanded these efforts to the area of malaria case management.

MALI: Jhpiego/ACCESS worked with USAID, the Mali government and partners to develop performance standards and assessment tools and adapt national training materials for Mali’s malaria in pregnancy program.

NIGERIA: With support from the ExxonMobil Foundation, Jhpiego is implementing an innovative program in four local government areas to strengthen antenatal care and integrate services for malaria in pregnancy with HIV clinical services. In addition, with support from USAID, Jhpiego is developing malaria in pregnancy guidelines and technical assistance to address program bottlenecks.

RWANDA: Jhpiego collaborated with MAC partners to support the adoption of a national malaria policy specific to pregnant women, facilitated the adaptation of training materials for focused antenatal care and malaria in pregnancy, and trained 40 trainers. The Ministry of Health is implementing this training with providers in health facilities.

TANZANIA: Jhpiego is collaborating with the Ministry of Health on a program to expand training of providers in antenatal care and malaria in pregnancy to all 5,000 health facilities in Tanzania by 2009; data from 56 facilities have already shown that use of malaria preventive treatment by pregnant women is twice the national average.

UGANDA: Jhpiego worked with faith-based organizations to improve the capacity of service providers and the knowledge of community health workers, contributing to increased use of malaria in pregnancy services during antenatal care at five health facilities.

ZAMBIA: Jhpiego collaborated with the government and other partners to adapt Zambia's malaria policy into revised service delivery guidelines and an orientation package on malaria in pregnancy, which were disseminated to all 72 districts and nine provincial offices in the country.

More Information

For more information on Jhpiego's malaria programs, browse the feature articles and news releases in the Media Center. Features include:

For additional resources, browse our Malaria in Africa Information Sheet and/or go to our online Publications Catalog. Resources include:

The following resources are available on other web sites:

* Focused antenatal care emphasizes the quality of individualized care rather than quantity of visits. WHO recommends four antenatal visits for women experiencing normal pregnancies. Focused antenatal care includes: identification of pre-existing health conditions; early detection of complications arising during pregnancy; health promotion and disease prevention; and birth preparedness and complication readiness.