Understanding pregnant women's uptake of malaria prevention interventions: The role of qualitative evidence

在许多发展中国家，孕期感染疟疾是一个重要的公共卫生问题，因为它对母亲和婴儿造成严重后果。生活在疟疾流行国家的孕妇比未怀孕的妇女更容易感染疟疾，及时治疗和获得预防疟疾的有效措施取决于妇女能否获得优质的产前护理服务。国际捐助者和区域领导人最近再次承诺向更多孕妇提供有效的疟疾预防干预措施。众所周知，在怀孕期间定期使用驱虫蚊帐并在怀孕中期和晚期至少接受两剂抗疟疾药物(间歇预防治疗或IPT)的孕妇患疟疾或遭受可能致命的感染的严重后果的可能性较小。疟疾控制规划难以实施像IPT或ITN这样简单有效的干预措施，部分原因是它们没有考虑到社区和孕妇？S对这些干预措施的反应和反应。国际捐助者大力宣传这些重要的公共卫生干预措施，试图增加受疟疾影响的社区的覆盖率，但真正的挑战在于改善实施情况，以鼓励孕妇接受ITNS和IPT。这项研究将汇集所有现有的证据，包括孕妇获得和使用ITNS和IPT的障碍和促进器，S获得和使用ITNS和IPT，妇女对干预措施的接受度，以及影响其接受的因素。利物浦热带医学院的研究人员和在非洲从事疟疾控制工作的同事们将通过一种名为研究综合的方法来完成这项工作，该方法总结了多项研究的结果。综合通过以更简洁的形式向政策制定者提供大量证据，使研究结果更容易获得。对这项研究进行关键和系统的总结对非洲疟疾控制方案的好处是显而易见的；如果有证据表明什么对孕妇和社区很重要，就可以更有效地设计和执行方案，以改进在怀孕期间使用注射用蚊帐和使用注射用蚊帐的妇女人数，并在怀孕期间采取预防性剂量的抗疟疾治疗，这对妇幼保健和生存以及实现千年发展目标4、5和6至关重要。

Malaria infection in pregnancy is an important public health concern in many developing countries because of the serious consequences for mothers and infants. Pregnant women living in countries where malaria is prevalent are more susceptible to malaria infection than non-pregnant women, and prompt treatment and access to effective measures to prevent malaria depends on women having access to good quality antenatal care services. International donors and regional leaders have recently renewed their commitment to reaching more pregnant women with effective malaria prevention interventions. It is known that pregnant women who regulalry use insecticide-treated nets (ITNs) throughout pregnancy and receive at least two doses of antimalarial drugs during the second and third trimesters (Intermittent Preventive Treatment or IPT) are less likely to acquire malaria or suffer the serious consequences of infection, which can be fatal.Malaria control programmes have struggled to implement simple and effective interventions like IPT or ITNs, in part because they have failed to take account of community and pregnant women?s reactions and responses to the interventions. International donors heavily promote these important public health interventions to try and increase coverage in communities affected by malaria, but the real challenge lies in improving implementation to encourage uptake of ITNs and IPT by pregnant women.This research will bring together all the available evidence on barriers and facilitators to pregnant women?s access and use of ITNs and IPT, women?s acceptability of the interventions, and factors influencing their uptake. Researchers based at Liverpool School of Tropical Medicine together with colleagues working in malaria control in Africa will do this by using a method called research synthesis that summarises results from across multiple studies. Synthesis makes research findings more accessible by bringing a body of evidence to policy makers in a more succinct format. The benefits to malaria control programmes in Africa of a critical and systematic summary of this research are obvious; equipped with evidence of what is important to pregnant women and communities, the design and implementation of programmes to improve the use of IPT and ITNs in pregnancy could be made more effective.Increasing the number of women using ITNs and taking preventive doses of antimalarial treatment during pregnancy is critical to maternal and child health and survival, and in achieving millennium development goals 4, 5 and 6.