TESTING STRATEGIES TO INCREASE USE OF CHLOROQUINE CHEMOPROPHYLAXIS DURING PREGNANCY IN MALAWI

The widespread problem of low and non-compliance to antimalarial chemo prophylaxis during pregnancy demands that attention be focused on alte rnative approaches to programming, product acceptability and demand fo r preventive services. This study describes the testing of three inter ventions to determine their effect on use of chloroquine (currently th e most widely used drug for chemoprophylaxis) during pregnancy. The st rategies evolved from community-based formative research undertaken to learn about the local concept of malaria and issues surrounding malar ia prevention and treatment during pregnancy. The resulting interventi ons were tested in four clinics, and included a change in the health e ducation message given during antenatal sessions, distribution of a su gar-coated chloroquine tablet, and an intervention combining the two s trategies. The results showed a 45% increase in chloroquine use when t he health education message was changed, and a 64% increase when the p roduct was changed. High use levels were maintained with the combined intervention; an additive effect was seen. The study shows that improv ing the product was the most important factor in increasing the use of the program, and that changing the hearth education message can also make an impact on use.