MALARIA AND CHILDBEARING WOMEN IN MALAWI - KNOWLEDGE, ATTITUDES AND PRACTICES

Information on women's use of antenatal clinic (ANC) service, includin g malaria prevention and treatment during pregnancy, was collected dur ing a national malaria knowledge, attitudes, and practices survey in M alawi. Among 1531 households, 809 (53%) included a woman who had carri ed a pregnancy past the second trimester within the past 5 years. Of t hese, 756 (93%) women reported at least one ANC visit during pregnancy (median=4); 336 (42%) attended 5 or more times. Approximately half (5 1%) reported delivering in a hospital; 5% delivered in a clinic; 13% d elivered at home with a trained birth attendant; and 28% delivered at home with only family attending. Women at increased risk for delivery complications (e.g. primigravidas and grand multigravidas) were no mor e likely to attend ANC or deliver in hospital than women without incre ased risk. The woman's level of education was the only significant pre dictor of initiating ANC care, continued ANC attendance, and delivery in hospital. In a setting where 43% of women pregnant within the past 5 years had received no formal education and 70% had completed less th an 5 years, this survey identified a critical need for targeting healt h messages towards poorly educated women to ensure proper utilization of antenatal care services, including coverage with malaria prevention throughout pregnancy.