World Malaria Day 2023 - LSTM Malaria in Pregnancy - the work of the team in LSTM Nigeria

Blog 24 Apr 2023

Malaria in pregnancy is prevented primarily by using Insecticide Treated Net (ITN) in pregnancy, indoor residual spraying, and Intermittent Preventive Therapy (IPT) with Sulphadoxine Pyrimethamine (SP) IPT-SP. IPT was introduced by WHO in 1998 and implemented in 2004 to replace chemoprophylaxis for malaria and recommended for pregnant women living in malaria-endemic areas.  (Briand, Cottrell, Massougbodji, et al, 2007).

Malaria accounts for 11% of maternal deaths in Nigeria and complicates up to 58.1% of pregnancies (Bello and Ayede, 2019). Nigeria adopted the new WHO IPT-SP policy of providing SP to pregnant women from the early second trimester till delivery. Although the policy was adopted by the Federal Ministry of Health, a lot of health workers do not have the knowledge as such it is not widely implemented in Antenatal (ANC) clinics.  Some health workers still use the previous recommendation of giving SP twice only during pregnancy. (Peters and Naidoo, 2020)

Liverpool School of Tropical Medicine funded by Global Fund with financing from Takeda Pharmaceutical Company Limited has been implementing the programme “Quality Improvement (QI) in Integrated HIV, TB and Malaria Services in ANC&PNC in Kaduna and Oyo state Nigeria” The programme is supporting capacity-building of Health Care Workers and health systems strengthening by promoting integrated, people-centred health services. The programme is implemented through training Health workers (doctors, nurses, midwives, and CHEWs) working in ANC&PNC clinics to acquire hands-on skills in the prevention diagnosis, and management of malaria amongst other things.

The programme is supporting 60 facilities in Kaduna and 60 in Oyo states. So far 252 health workers in Kaduna and 188 in Oyo have been trained in ANC&PNC. After the training the health facilities are supported to establish Quality Improvement teams and conduct Standard Based Audits (StBA) in ANC&PNC. There is an on-going support for the health workers through a mentorship programme implemented in both states.

Through our work most of the facilities introduced routine screening for malaria during booking visit using rapid diagnostic testing, implementation of IPT-SP according to the WHO recommendations and improved case management for malaria and referral services. Most of the facilities especially the primary health centres provide ITN for pregnant women supplied through other malaria programmes in Nigeria.

As we celebrate World Malaria Day, we will double our effort to continue to provide training and retraining with mentorship to health workers in Nigeria. Together with the efforts of other stakeholders, we will move closer to the goal of eliminating malaria in Nigeria.  


Bello FA, Ayede AI. Prevalence of Malaria Parasitaemia and the use of malaria prevention measures in pregnant Women in Ibadan, Nigeria. Ann Ib Postgrad Med. 2019 Dec;17(2):124-129. PMID: 32669988; PMCID: PMC7358809.

Briand, V., Cottrell, G., Massougbodji, A. et al. Intermittent preventive treatment for the prevention of malaria during pregnancy in high transmission areas. Malar J 6, 160 (2007).

Peters GO, Naidoo M. Factors influencing the use of intermittent preventive treatment of pregnant women seeking care at primary healthcare facilities in the Bwari Area Council, Abuja, Nigeria. Afr J Prim Health Care Fam Med. 2020 Apr 16;12(1):e1-e8. doi: 10.4102/phcfm.v12i1.2256. PMID: 32370528; PMCID: PMC7203208.

Schantz-Dunn J, Nour NM. Malaria and pregnancy: a global health perspective. Rev Obstet Gynecol. 2009 Summer;2(3):186-92. PMID: 19826576; PMCID: PMC2760896.

WHO. (2022). World Malaria Report 2022. Retrieved from