Qualitative Research on Intermittent Preventive Treatment for Malaria during Pregnancy in Rural Zambia

The study aimed to explore the perceptions and experiences of pregnant women and their male partners regarding malaria prevention and treatment during pregnancy. Pregnant women in rural Zambia reported various physical changes during pregnancy, including intuition that they had conceived, missing menstrual periods, fluctuations in appetite, illness, vomiting, fatigue, irritability, changes in the breasts, skin fluctuations, fetal movements, and size of the bump. The first communication about the suspected pregnancy was often made to the male partner, with 71% of women reporting that their partner was the first to be informed. Male partners played a significant role in supporting pregnant women during pregnancy and childbirth. Financial support was the most common form of support, with 85% of women reporting that their partner provided financial assistance. Emotional support was also crucial, with 75% of women reporting that their partner provided emotional support. However, some women reported that their partner's response to the news of pregnancy was negative, with 15% of women reporting that their partner was not supportive. Barriers to accessing antenatal care (ANC) services were identified as HIV testing, ANC providers, finances, male partners, maternity clothes, lack of awareness of ANC benefits, distance to the health facility, laziness, tradition, previous delivery experience, age, parity, and community sensitization for increased ANC utilization. On the other hand, facilitators of ANC services included male partners, pregnancy confirmation, awareness of ANC prevention benefits, registration card, information and education at ANC, malaria prevention, HIV testing, prevention of anemia, nutrition advice, position of fetus in uterus, fetal health, fetal growth, maternal health, first pregnancy, illness during pregnancy, safe delivery, incentives, leader fees, and integration. The study found that early initiation of ANC was recommended, but actual initiation was often much later. Barriers to timely ANC access included ensuring pregnancy, pregnancy bump and quickening, fetus formed, shyness, finances, tradition, ignorance, witches, lack of illness, and unknown. The number of ANC visits was also a concern, with some women reporting that they did not attend ANC visits regularly due to various reasons. ANC services were found to be essential for pregnant women, with services including HIV testing, malaria prevention, prevention of anemia, nutrition advice, position of fetus in uterus, fetal health, fetal growth, maternal health, first pregnancy, illness during pregnancy, safe delivery, incentives, leader fees, and integration. The study highlights the importance of male partner involvement in ANC services and the need for community sensitization to increase ANC utilization.