Among malaria’s more devastating effects is the heavy burden it places on pregnant mothers and young children. According to the World Health Organization (WHO) 2023 World Malaria Report, more than 12.5 million African women were infected with malaria during pregnancy in 2022, contributing to nearly 1 million babies being born with low birth weight—a significant risk factor for infant and childhood mortality.
To fight back against the burden of malaria on pregnant mothers in Zambia’s Eastern province, the U.S. President’s Malaria Initiative (PMI) PAMO Plus project—funded by PMI and implemented by PATH—is partnering with the Zambian government to expand access to key malaria prevention tools among pregnant women.
As part of this effort, PMI PAMO Plus is training Safe Motherhood Action Groups (SMAGs) to help mothers to protect themselves and their babies from malaria. SMAGs engage pregnant women directly to give them the information they need to take proactive steps to prevent malaria and the encouragement to apply it.
SMAGs encourage pregnant women in their communities to seek antenatal care, where they can receive intermittent preventative treatment in pregnancy (IPTp) and insecticide-treated bed nets to help protect against the substantial health risks malaria places on both mother and baby—including low infant birth weight, maternal death before and after childbirth, and pregnancy loss and stillbirth. They also help promote healthy pregnancies and improve maternal health by providing health services in communities, recommending complex malaria cases to health centers, and encouraging women to deliver their baby at a health facility.
“SMAGs are making significant contributions to maternal health outcomes in Eastern Province by encouraging pregnant women to take malaria preventive medications to protect themselves and their unborn child from the devastating effects of malaria,” said Dr. Webby Phiri, Technical Director for PMI PAMO Plus.
SMAG members conduct a community dialogue in Muduwa, Mkanda, Eastern Province. Photo: PATH/Joy Talemwa
Vubwi District, located in Zambia’s Eastern Province, has seen a significant increase in the number of pregnant women receiving the WHO-recommended three doses of IPTp that protect mothers and children from malaria. In the past, far fewer women were receiving antenatal care within the first three months of pregnancy, which in turn significantly reduced the number of women receiving the full recommended course of preventative medication.
According to Sydney Nsooka, District Nursing Officer in Vubwi District, SMAGs played an important role in these improvements. “The motivation of SMAGs coupled with a good supply of Fansidar [a malaria medication used in pregnancy] has increased the number of pregnant women using malaria prevention drugs,” said Nsooka.
Myths, misconceptions, and inadequate access to correct information were all significant barriers to women in Vubwi District seeking antenatal care early in pregnancy. PMI PAMO Plus and the Zambia National Malaria Elimination Centre have helped address these barriers by strengthening the skills SMAG members need to educate their community on malaria in pregnancy. Today, pregnant women in Vubwi District are embracing antenatal care even during the early stages of pregnancy.
A Safe Motherhood Action Group in Vubwi District. Photo: PATH/Melody Simataa.
The dedicated SMAGs in Vubwi District shared that they commit their time to this effort because they are passionate about educating mothers on how to take action against malaria. They recall times when pregnant mothers would regularly become ill with malaria and, in some complex cases, face life-threatening maternal anemia because of the disease.
However, thanks to their continuous efforts to engage their communities, things are changing. The number of pregnant women infected with malaria is steadily decreasing—from 54 in 2020 to just 1 in 2023. Seeing this progress inspires SMAGs to continue their work helping mothers fight back against malaria.
