Malaria is an infectious disease transmitted through mosquito bites of certain kinds of female mosquitoes (of the genus Anopheles). The global burden is massive and particularly high in developing tropical and subtropical countries, where pregnant women represent one of the most vulnerable categories. Given the curative and preventative options currently available, malaria should virtually be an eradicated disease. However, deep-rooted stigmas about malaria and misinformation persist and obstruct those efforts. This article sheds light on the public health fallout from maternal malaria, the stigmas that hamper accurate diagnoses and lead to false perceptions about the disease that wrongly prevent women from getting the proper treatment and preventative care.
Understanding Maternal Malaria
What is Maternal Malaria?
Maternal malaria is an infection with malaria that occurs during pregnancy. During pregnancy, changes in a woman’s physiology can compromise her immune response to the malaria parasite causing disease, and these changes also confer vulnerability on the fetus. In-utero infection can result in maternal anemia, low birth weight, preterm birth, and maternal and infant death.
Why is Maternal Malaria a Concern?
In addition, pregnant women are particularly vulnerable to death from malaria. This is because pregnancy itself weakens the immune system to prevent it from attacking the growing baby. Malaria results in several health consequences, such as:
- Anaemia: The malaria parasite destroys red blood cells, resulting in potentially life-threatening anemia in pregnant women.
- Low Birth Weight: Babies exposed to malaria suffer more frequently from low birth weight, which increases neonatal complications and mortality.
- Pre-term Birth: Maternal malaria increases the risk that a pregnancy will end in early labor and delivery, which increases the risk of health problems for the baby.
- Maternal Mortality: Severe malaria can increase maternal mortality rates for women living in areas in which the disease is prevalent.
The Stigma Surrounding Maternal Malaria
Cultural and Social Stigma
Perhaps most importantly, stigma has been identified as one of the major causes of poor management of maternal malaria in many places where it is still a problem. In some communities, infections stem from poor personal hygiene or poor lifestyle choices and might therefore attract blame and shame for affected individuals, which in turn leads to:
- Cultural beliefs about the transmission of disease: The notion that malaria is transmitted through faulty hygiene practices could give rise to an irrational blaming of affected individuals or their families.
- Social Isolation: If a woman develops malaria while pregnant, she might then experience social isolation or rejection within her community, which creates an additional disincentive to seek treatment.
- Fear of Medical Stigma: Pregnant women may also have fears about the judgments that healthcare providers will make about them (‘Do you think I am stupid because I was not tested for HIV before becoming pregnant?’) or about the looks they would get in the doctor’s office if they were to disclose their previous HIV diagnosis.
Impact on Health-Seeking Behavior
Stigma and misunderstanding can also influence behavior, leading some women to delay treatment or to refuse care altogether out of embarrassment. When it comes to stigma and the mental and physical health of women, the burden can be especially great. This is because pregnancy is a sensitive time for many, says Katz. The psychological stress and fears associated with pregnancy can exacerbate the negative effects of broader stigma. To make matters worse, both pregnant women and their babies are also more susceptible to malaria infection. Moreover, stigma can undermine public health efforts to control and prevent malaria, thwarting the efforts of policymakers intent on eradicating the disease. But stigma can also operate at a much more subtle level, discouraging open discussion about how malaria spreads. In the end, scaling up education about the disease remains an effective way of reducing the stigma associated with malaria and preventing transmission.
Encouraging Treatment and Preventive Care
Education and Awareness
One of the first and perhaps the most effective ways to fight stigma and increase treatment rates is through education and awareness. Public health campaigns should concentrate on:
- Dispelling the myth: education about malaria transmission, prevention, and treatment can reduce the stigma surrounding the infection.
- Promoting the Benefits of Treatment: A focus on encouraging the acceptance and benignity of early treatment and preventive measures can promote the uptake of care among pregnant women, and eliminate any judgments.
- Uplifting Success Case Studies: She can identify women who succeeded with malaria in pregnancy (MiP) and share their stories.
Strengthening Healthcare Services
Access to and quality of healthcare services to help manage maternal malaria should be improved through:
- Training their healthcare providers: Teaching healthcare providers to provide non-judgmental, empathetic care in an unbiased fashion can also help alleviate stigma and encourage women to seek treatment.
- Increase Affordable Care: Making malaria drugs and preventive measures affordable for all can lower the barriers to care.
- Improving tests and diagnosis: along with the availability of rapid diagnostic tests, enhances the timeliness of diagnosis. This increases the chances that patients will receive prompt treatment and recover effectively. By streamlining the diagnostic process, we can ensure better health outcomes for those affected by malaria.
Community Involvement
Community engagement plays a vital role in combating stigma and promoting health. Strategies include:
- Involving Community Leaders: Supporters can motivate local opinion leaders to support malaria prevention and treatment programs, and then facilitate them. This will influence a shift in community attitude and subsequently supportive behavior.
- Forming Support Networks: Creating social support networks for pregnant women, such as access to birth groups both online and offline, can provide emotional and social support and allow women to access care without experiencing stigma.
- Encouraging Open Dialogue: Open discussion of malaria at the community level can help normalize the disease and reduce stigma.
Implementing Preventive Measures
Preventive measures are crucial in reducing the incidence of maternal malaria. Key strategies include:
- Insecticide-treated nets (ITNs): Provision to pregnant women can lead to a significant decrease in mother-to-child transmission of malaria at night.
- Intermittent Preventive Treatment (IPT) with Sulphadoxine-Pyrimethamine (SP) is administered during high-risk periods throughout pregnancy to prevent infections and their complications.
- Additionally, effective environmental management plays a crucial role in malaria prevention. By removing or managing mosquito breeding sites, we can significantly reduce the likelihood of malaria transmission.
The campaign of malaria stigma and misinformation against maternal malaria is a major public health problem. To tackle this issue, we recommend a multifaceted approach that includes an educational campaign, enhanced healthcare services, community involvement, and effective antimalaria prevention measures. Reducing the stigma surrounding maternal malaria is crucial. By ensuring pregnant women receive early treatment and access to preventive measures, we can transform this condition into one that is manageable and easily treatable. This proactive strategy will significantly improve health outcomes and contribute to global efforts to combat malaria.
