Socio-Cultural Perceptions Hinder Treatment of Malaria in Pregnant Women

Beliefs and perceptions by pregnant women that they are not at risk of contracting malaria discourages most of them from prevention and treatment efforts of the disease in Sub-Saharan Africa (SSA).

Available records from the National Malaria Control Programme of the Ghana Health Service however showed that malaria in pregnancy was common in malaria endemic regions of the country and accounted for 17.6 per cent of OPD (Out-Patient-Attendance), 13.7 per cent of admissions and 4.3 per cent of maternal deaths in 2015, alone.

The study, “Social-cultural motivators and de-motivators to malaria prevention and treatment among pregnant women in sub Saharan Africa: A Review,”  was presented during the Developing Excellence in Leadership, Training and Science (DELTAS) Africa annual grantee meeting in Accra.

This study sought to understand existing research findings on community related factors that influence pregnant women’s decision to prevent and manage malaria infections.

The researchers identified 60 peer reviewed articles, international journal published between 2005-2016 in SSA countries including Ghana, Kenya, Nigeria, Malawi, South Africa from PubMed and other sources, and assessed factors that motivate or de-motivate women regarding adhering to interventions for prevention and management of malaria.

A qualitative computer software Nvivo was used to assist in coding and analysis of data. The results presented were based on the analysis.

Dr Matilda Aberese-Ako, lead researcher, and a postdoctoral research fellow of the University of Health and Allied Sciences, Ho, speaking to the Ghana News Agency last Friday said interpersonal, community, environment and socio-cultural factors influenced pregnant women to either prevent or treat malaria.

“There is a perception in Sub-Saharan Africa that malaria is not dangerous, but it is one of the serious killers of people and influence decision to prevention and treatment,” she told the Ghana News Agency.

“Others believe that there could be supernatural forces when a pregnant woman is sick and people relate it to spiritual forces making them end up seeing herbalists and spiritualists.”

The study found that pregnant women especially those who were illiterate had poor knowledge of malaria, which served as a de-motivator to preventive efforts.

Nevertheless, women, who were economically well off and older were more motivated to access malaria interventions.

In spite of proven effective interventions to control malaria infections among pregnant women in SSA, current indicators suggested that there were still incidents of miscarriages, neonatal deaths, and maternal morbidity and mortality resulting from malaria infections among pregnant women in Ghana.

Gaps from such findings were aimed at informing the Malaria Research Capacity Development in West and Central Africa (MARCAD) team based in Ghana to carry out further research studies in two communities in Ghana.

Pascal Magnussen, a co-supervisor of the study and an associate professor of parasitology at the University of Copenhagen, Denmark, explained that practices, perceptions and attitudes were important determinants of how people accepted and took up public health interventions, including vaccinations and medicines.

He recommended more communication, information and education materials to positively change the beliefs and attitudes of people in regards to malaria.

Sharon Fonn, a professor of Public Health at South Africa’s University of the Witwatersrand recommended investment in better malaria control, including use of bed nets.

“People using bed nets certainly need encouragement,” she added.

The global situation as at 2016 is that, there were 216 million cases of malaria infections recording 445,000 deaths globally, triggering a call by the WHO Global Technical Strategy for Malaria for reduction in at least 40 per cent in case incidence and mortality rates by 2020, expressing apprehension of possible loss of track to reach this milestone.

The review was aimed at informing the MARCAD team in Ghana, which was led by Professor Harry Tagbor of UHAS, Ho, the gaps in research on community behaviours and attitudes that affected the effective control of malaria related infections in pregnancy.

According to Dr Aberese-Ako, the study was yet to be published in a peer-reviewed journal. Also a field research study had been designed based on the findings from the review for further research work using ethnography in the Volta and Ashanti regions, where work was progressing robustly.

The study will offer the opportunity to better understand deep seated community beliefs and attitudes that influence pregnant women’s decisions to control malaria infections.

It will again give room to designing malaria interventions that will meet the needs of the different categories of pregnant women.

Source: GNA