Changing the policy for intermittent preventive treatment with sulfadoxine–pyrimethamine during pregnancy in Malawi

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dc.contributor.author Mwendera, Chikondi
dc.contributor.author De Jager, Christiaan
dc.contributor.author Longwe, Herbert
dc.contributor.author Phiri, Kamija
dc.contributor.author Hongoro, Charles
dc.contributor.author Mutero, Clifford M.
dc.date.accessioned 2017-03-14T10:20:15Z
dc.date.available 2017-03-14T10:20:15Z
dc.date.issued 2017-02-20
dc.description.abstract BACKGROUND : The growing resistance of Plasmodium falciparum to sulfadoxine–pyrimethamine (SP) treatment for uncomplicated malaria led to a recommendation by the World Health Organization for the use of artemisinin-based combination therapy. Inevitably, concerns were also raised surrounding the use of SP for intermittent prevention treatment of malaria during pregnancy (IPTp) amidst the lack of alternative drugs. Malawi was the first country to adopt intermittent prevention treatment with SP in 1993, and updated in 2013. This case study examines the policy updating process and the contribution of research and key stakeholders to this process. The findings support the development of a malaria research-to-policy framework in Malawi. METHODS : Documents and evidence published from 1993 to 2012 were systematically reviewed in addition to key informant interviews. RESULTS : The online search identified 170 potential publications, of which eight from Malawi met the inclusion criteria. Two published studies from Malawi were instrumental in the WHO policy recommendation which in turn led to the updating of national policies. The updated policy indicates that more than two SP doses, as informed by research, overcome the challenges of the first policy of two SP doses only because of ineffectiveness by P. falciparum resistance and the global lack of replacement drugs to SP for IPTp. CONCLUSION : International WHO recommendations facilitated a smooth policy change driven by motivated local leadership with technical and financial support from development partners. Policy development and implementation should include key stakeholders and use local malaria research in a research-to-policy framework. en_ZA
dc.description.department School of Health Systems and Public Health (SHSPH) en_ZA
dc.description.librarian am2017 en_ZA
dc.description.sponsorship University of Pretoria Institute for Sustainable Malaria Control (UP ISMC) and MRC Collaborating Centre for malaria research. en_ZA
dc.description.uri http://www.malariajournal.com en_ZA
dc.identifier.citation Mwendera, CA, De Jager, C, Longwe, H, Phiri, K, Hongoro, C & Mutero, CM 2017, 'Changing the policy for intermittent preventive treatment with sulfadoxine–pyrimethamine during pregnancy in Malawi', Malaria Journal, vol. 16, art. no. 84, pp. 1-13. en_ZA
dc.identifier.issn 1475-2875
dc.identifier.uri http://hdl.handle.net/2263/59421
dc.language.iso en en_ZA
dc.publisher BioMed Central en_ZA
dc.rights © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. en_ZA
dc.subject Malaria en_ZA
dc.subject Pregnancy en_ZA
dc.subject Sulfadoxine–pyrimethamine en_ZA
dc.subject Policy change en_ZA
dc.subject Malawi en_ZA
dc.title Changing the policy for intermittent preventive treatment with sulfadoxine–pyrimethamine during pregnancy in Malawi en_ZA
dc.type Article en_ZA


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