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

在许多发展中国家，怀孕期间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非孕妇更容易感染疟疾，及时治疗和采取有效措施预防疟疾取决于妇女获得优质产前保健服务。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，在整个怀孕期间经常使用驱虫蚊帐并在第二和第三孕期接受至少两剂抗疟药物的孕妇，（间歇性预防治疗或IPT）的人感染疟疾或遭受严重感染后果的可能性较小，感染后果可能是致命的。疟疾控制方案一直在努力实施简单有效的干预措施，如IPT或驱虫蚊帐，部分原因是他们没有考虑到社区和孕妇？的反应和对干预措施的反应。国际捐助者大力推广这些重要的公共卫生干预措施，试图增加受疟疾影响社区的覆盖率，但真实的挑战在于改善实施情况，鼓励孕妇使用驱虫蚊帐和IPT。这项研究将汇集所有关于孕妇使用驱虫蚊帐和IPT的障碍和促进因素的现有证据？妇女获得和使用经杀虫剂处理过的蚊帐和经杀虫剂处理过的蚊帐的情况如何？的干预措施的可接受性，以及影响其吸收的因素。利物浦热带医学院的研究人员和在非洲疟疾控制领域工作的同事们将通过一种名为研究综合的方法来完成这一工作，该方法总结了多项研究的结果。综合以更简洁的形式向决策者提供大量证据，使研究结果更容易获得。对这项研究进行批判性和系统性的总结，对非洲疟疾控制方案的好处是显而易见的;配备了对孕妇和社区重要的证据，可以更有效地设计和执行方案，改善怀孕期间使用驱虫蚊帐和驱虫蚊帐的情况，增加怀孕期间使用驱虫蚊帐和接受预防性抗疟治疗的妇女人数，以及儿童健康和生存，以及实现千年发展目标4、5和6。

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.