Determinants of Malaria in Pregnancy and women's experiences with prevention in Mansa District, Zambia: A Mixed-Methods Exploratory Study

Background: Malaria in pregnancy is predominant in Sub-Saharan Africa. It is one of the major causes of abortion, prematurity low birth weight and anaemia in pregnancy. One of the legacy goals for Ministry of health in Zambia was to eliminate Malaria by the year 2021. Many efforts are put in place but the prevalence is still high in some parts of Zambia. Therefore, this study explored the determinants of malaria in pregnancy and experiences of women on access to resources meant for Malaria prevention in Mansa district. Method: A mixed-methods and exploratory research design was conducted in four selected settings of Mansa district. Quantitative data was retrospectively collected from 236 antenatal records sampled by systematic random method. Qualitative data was collected from 25 post-natal women and 5 Nurses through in-depth face-to-face interviews; using semi-structured interview guide and participants were purposively sampled. Chi-square and thematic analysis were used for quantitative and qualitative data respectively. Results: Prevalence of Malaria in pregnancy was at 14.8% and ownership of insecticide-treated bed-nets was at 72%. Late antenatal booking led women to miss insecticide-treated bed-nets and Sulphadoxine-Pyrimethamine doses. Knowledge gap also affected the uptake of Sulphadoxine-Pyrimethamine and Insecticide treated bed-nets. Conclusion: The primary prevention of malaria in pregnancy was sub-optimal in Mansa district. This calls for improvement of timely antenatal booking and ensuring distribution of Insecticide-treated bednets to every pregnant woman. More resources are needed as well as civic education and effective participation of women attending antenatal services.