Publish Date: January 2014
Author: Elaine Roman, Michelle Wallon, William Brieger, Aimee Dickerson, Barbara Rawlins, Koki Agarwal
This article, published in the journal Global Health: Science and Practice, describes the results of a systematic case study methodology to assess health system strengths and challenges as they relate to malaria in pregnancy (MIP) in Malawi, Senegal and Zambia. Data were collected between 2009 and 2011 through desk reviews and key informant interviews. The data were subsequently analyzed across eight MIP health system components (integration of programs and services, policy, commodities, quality assurance, capacity building, community involvement, monitoring and evaluation, and financing). Findings showed that all three countries had malaria policies in place consistent with the World Health Organization’s MIP guidance, and had also successfully integrated MIP interventions into a platform of antenatal care services. However, coordination at the national level was disjointed, only Malawi had an MIP focal person, commodity stock-outs were frequent, there was a lack of support for quality assurance, and monitoring and evaluation mechanisms were weak. The authors conclude that MIP programs should address all eight interconnected MIP health system areas holistically, in the context of a health systems approach. The article’s MIP table of analysis can be a useful tool for other malaria-endemic countries to review their programs and improve MIP outcomes.
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