Evaluating the Impact of Community-Based Intermittent Preventive Treatment on Malaria Incidence Among Pregnant Women in Rural Uganda: A Cluster Trial

Malaria remains a major cause of maternal morbidity and adverse pregnancy outcomes in sub-Saharan Africa, with rural Uganda experiencing significant challenges in ensuring effective intermittent preventive treatment during pregnancy (IPTp). Community-based intermittent preventive treatment (C-IPTp) offers a promising approach to overcoming barriers such as healthcare inaccessibility and poor adherence to facility-based IPTp. This review evaluated the impact of C-IPTp on malaria incidence among pregnant women in rural Uganda using evidence from a cluster trial methodology, where villages or health sub-districts were assigned either to the intervention or to standard facility-based IPTp. The review synthesized data on malaria incidence reduction, maternal and neonatal health improvements, and increased IPTp coverage through community health worker (CHW) engagement. Findings indicated that C-IPTp significantly enhances adherence, reduces malaria prevalence, and lowers maternal anemia and low birth weight rates. However, challenges such as drug stockouts, community acceptability, and health system integration must be addressed to optimize implementation. Strengthening CHW support, improving drug supply chains, and enhancing community sensitization are critical for sustainable success. Policymakers should integrate C-IPTp into Uganda’s national malaria strategy, ensuring long-term feasibility and scalability for enhanced maternal health outcomes. Keywords: Community-based intermittent preventive treatment (C-IPTp), Malaria prevention in pregnancy, Maternal health in rural Uganda, Cluster trial methodology, Community health workers (CHWs).