Malaria continues to pose a significant health challenge, particularly in tropical and subtropical areas where its impact on maternal and child health is greatest. Specifically, malaria is a mosquito-borne disease transmitted through the bites of infected Anopheles mosquitoes, which account for approximately 228 million cases of fever and 781,000 deaths each year. Notably, pregnant women and young children are at the highest risk. Therefore, for the health of mothers and babies, robust malaria prevention programs, supported by appropriate policies, need to be in place. Consequently, this article discusses why policy change should be a primary focus for strengthening malaria prevention programs aimed at improving maternal and child health, as well as the strategies that can help advocates achieve success.
The Impact of Malaria on Maternal and Child Health
Malaria is more dangerous for pregnant women and young children, and so it should be countered by targeted prevention:
- Pregnant Women: Foetal and maternal malaria disease manifests in severe anemia, preterm birth, low birth weight, and maternal/fetal death. Pregnant women are more vulnerable to malaria due to their physiological immune system alterations and are a high-risk group for malaria morbidity and mortality.
- Children under five: Immunologic defenses are still developing in young children, making them among the most vulnerable to the disease. Complications of severe malaria in these children often lead to severe morbidity and long-lasting development issues. It is a leading cause of death among children in endemic areas.
Effective malaria control measures that specifically target these vulnerabilities will be essential for improving maternal and child health.
Why Policy Change is Essential
Policy change is an important educational tool for improving and targeting better malaria prevention programs for maternal and child health:
- Money and supplies: Policy change can increase funding for malaria control programs. Sufficient resources are also required to undertake preventive measures such as distributing ITNs, supplying antimalarial drugs, and implementing IRS.
- Standardizing Protocols: First and foremost, policies can mandate standardized protocols for malaria prophylaxis and treatment. This approach not only ensures consistency in the quality of care but also encourages the adoption of best practices across regions and healthcare facilities.
- Into Health Systems: Furthermore, policies can be influenced to integrate malaria prevention efforts into existing maternal and child health programs. This more cost-effective approach guarantees a dedicated space for malaria prevention within routine healthcare, thereby reaching a larger number of children.
- Improved Monitoring and Evaluation: Additionally, policy changes can require the establishment of a robust system to monitor and evaluate the impact of malaria control programs. This requirement helps to refine strategies based on what works effectively.
- Community mobilization: Policies can support community mobilization and awareness campaigns. For instance, engaging communities can increase the uptake and sustainability of malaria programs.
Key Strategies for Advocating Policy Change
Successfully advocating for policy change requires a strategic approach. Here are some effective strategies:
1. Build a Strong Evidence Base
- Data Collection: Gather and share statistics on the extent to which malaria affects maternal and child health, for example, morbidity and mortality statistics, case studies, and evidence from existing programs.
- What the research says: Reference research studies indicating the effectiveness of ITNs and IRS in helping to prevent malaria, and the resulting health benefits for pregnant women and children.
2. Engage Stakeholders
Engage with relevant government officials and policymakers to advocate for policy shifts Ensure that policymakers and influential government officials are aware of emerging scientific evidence on the effectiveness of intense malaria prevention and the gains for maternal and child health.
- Healthcare Providers Engage with healthcare providers to learn about the barriers they face when providing malaria prevention services and gain buy-in to support policy changes.
- Non-Governmental Organisations (NGOs): Partner with NGOs and other organizations engaged in malaria prevention to strengthen advocacy efforts and take advantage of their technical expertise and network.
3. Raise Public Awareness
- Media Campaigns: media campaigns that inform the public about the impact of malaria on maternal and child health outcomes, and the need for policy change can be implemented via social media, traditional media, and community outreach.
- EDUCATIONAL PROGRAMS: Create educational programs that expose the general public to information on malaria prevention, and stress the need for supportive policies.
4. Develop Policy Recommendations
- Policy Briefs: Write succinct policy briefs articulating the problem, proposed solution, and projected results for different audiences (e.g., policy-makers, healthcare professionals, and the general public).
- Action Plans: Write detailed action plans describing the steps necessary to enact policy changes, including the resources needed, timelines, and the actors responsible.
5. Advocate at Multiple Levels
- Local and National Advocacy: When advocacy isn’t being done on the local level, there’s little chance to address community needs. Thus, simultaneously advocating locally and nationally can pay off.
- International Support: Engage with international agencies that address malaria prevention or maternal and child health. Their endorsement could also attract additional financial resources for advocacy.
6. Monitor and Evaluate Advocacy Efforts
Monitor progress: One way advocates can track how their efforts are yielding results is by monitoring changes on the ground, including in policies and resource allocation, and in how programs are implemented.
Feedback Mechanisms: Set up feedback mechanisms to collect feedback from stakeholders and beneficiaries, and ensure that the feedback is used to inform or adjust the advocacy strategy to maintain its effectiveness.
Successful Examples of Policy Advocacy
Many advocacy campaigns have led to real progress in malaria prevention and maternal and child health:
1. The Roll Back Malaria Partnership
Roll Back Malaria (RBM), the global partnership aimed at controlling malaria, has been a clear success. Through public education and an activist approach, RBM has not only generated extensive support for funding and policy but also mobilized governments, NGOs, and international organizations. Consequently, this collective effort has helped implement and expand comprehensive malaria control programs in several countries, thereby reducing both morbidity and mortality.
2. The Global Fund to Fight AIDS, Tuberculosis, and Malaria
Global Fund support for malaria prevention in many countries has significantly strengthened their malaria-elimination capacity. As a result, this support has led to better health outcomes for pregnant women and children than would have otherwise been possible.
support has been essential in sustaining these programs and addressing emerging challenges.
3. The Malaria No More Campaign
The ‘Malaria No More’ campaign has mobilized key policymakers and antimalarial donors by expressing a clear call to action and by lending a voice to that action. These campaigns employ various communication tactics, such as public awareness and high-level advocacy, to create a specific atmosphere conducive to political commitment and financial resources for specific health and development programs.
Overcoming Challenges in Policy Advocacy
How to start advocating for policy change? These are some common barriers and strategies to get around them.
1. Limited Resources
Challenge: Advocacy efforts often require significant resources, including funding, time, and expertise.
Strategy: Establish partnerships with NGOs, academic institutions, and international agencies to pool resources and expertise, as well as partner with foundations, grantmaking agencies, and corporate sponsors in carrying out our advocacy work.
2. Political and Bureaucratic Hurdles
Challenge: Navigating political and bureaucratic processes can be complex and time-consuming.
Strategy: Cultivate a close relationship with policymakers and government officials to lubricate the process. Engage in some form of dialogue regularly to show them how urgent and beneficial the proposed policy changes will be.
3. Lack of Public Awareness
Obstacle: Public and community awareness that malaria negatively impacts maternal and child health is probably low.
Strategy: Use specific communications strategies to raise awareness and build public support: different messages to different audiences, through a multitude of platforms to reach as many people as possible.
4. Resistance to Change
There are in-house customers with established ways of working and set mindsets. Policy changes can be opposed by groups paying attention to entrenched interests. There can be pessimistic attitudes towards new efforts (there is a long history of failed health initiatives that casts a negative light on suggestions to start something new).
Strategy: ensure that proposed changes can be justified by clear, well-evidenced arguments that show the positive consequences, and involve potential stakeholders in developing the policies themselves, so that their legitimate concerns can be addressed and their support mobilised.
Fighting for policy change regarding strengthening malaria prevention programs is a crucial recommendation to improve maternal and child health outcomes. In this effort, everyone from the community, advocates, public health workers, political leaders, NGOs, and all stakeholders can play a vital role in enhancing health outcomes. For instance, building evidence-based arguments to advocate for policy change, raising public awareness, and engaging in strategic planning are key components of promoting better malaria prevention policies. Furthermore, the window of opportunity is here, now, and always. Moreover, the factors that make vulnerable people more susceptible to malaria being pregnant, being young, and lacking access to proper care remain unchanged. Therefore, we must learn from the devastating cholera outbreak in Zambia, which cost the lives of many children, and subsequently strengthen existing malaria prevention policies to reach those who need them the most.
Strong policy backstops lead to more robust and sustained malaria prevention programming, which, along with improved health outcomes, contributes to long-term maternal and child health gains. If we direct our advocacy energies and efforts towards these areas, we should be able to make a meaningful impact on how we prevent malaria globally.
