SUCCESS STORIES

Antenatal Clinics Key to Preventing Malaria among IDPs

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At the Unyama Health Center in rural northern Uganda, it is a normal day for this time of year – the sun is bright, the air temperature is burning hot, and the clinic is full. Waiting in the shade on wooden benches along the clinic’s front porch are about a dozen pregnant women, some accompanied by young children.  Even on this hot day, they have walked up to five kilometers from their homes in surrounding Internally Displaced Persons (IDP) camps to this health clinic for antenatal care.

Kiden Nancy Odong is the head administrator for this and several other clinics surrounding the camps.  Odong is a regal woman and seasoned health care provider who understands that antenatal visits are a crucial intersection between the those most vulnerable to malaria – pregnant woman and children under age five - and the health system that is working so hard to prevent and treat the disease. 

Beginning three years ago, every pregnant woman at the clinic receives a free, long lasting insecticide treated bed net (LLIN) to use at home and a dosage of drugs that will prevent her from contracting malaria during their pregnancy. 

“Our nurse in charge of antenatal care does a good job educating the expecting mothers and explaining to them the importance of the Intermittent Preventative Treatment drugs (IPT).  So when they do receive it, they understand that it’s protecting them from malaria,” said Odong.

Each moment at the clinic is treated as an opportunity to teach the women good practices to keep themselves and their families’ malaria free.  In the waiting area, the women’s attention is focused on a man standing in front of them holding a colorful, illustrated poster.  Pointing carefully to each illustration, the man gives step-by-step instructions on how to properly hang and use the bed net they will be receiving.  The illustrative instructions outline the basic care for a net (rolling it up during the day), how to repair a net that has a hole (leave no holes), and when it should be replaced with a newly treated net (for LLINs, after 20 washes or about three years). 

Posted on the walls, inside and outside of the clinic, are other posters and materials reinforcing the messages and instructions each woman will receive during their consultation with health workers and nurses at the clinic.

The scene here is repeated in hundreds of antenatal care clinics throughout Uganda.  Aciro Ketty, the nurse in charge of antenatal care says she sees a minimum of 15 patients a day. 

“We make sure every woman that’s pregnant gets a net.  If for some reason we are out on that day, we tell her to come back to make sure she gets one,” said Ketty.  The clinic serves thousands of residents living in IDP camps in the surrounding area, where conditions of overcrowding and poor sanitation provide on-going opportunities for mosquitoes to breed.  “Standing water and exposed rubbish are a problem in the camps so mosquitoes keep coming back,” Ketty said. “But we must not give up.” 

She believes the clinics are doing a good job of protecting pregnant women now and should try to help other groups such as the elderly.  “Our clinic is strong because of the cooperation with AFFORD and the Malaria Consortium,” said Ketty.

Most of the clinic’s resources, such as insecticide treated nets, malaria prevention drugs and educational materials are supplied through the health marketing initiative, AFFORD, a President’s Malaria Initiative supported program, and Malaria Consortium. They work in tandem with the Ministry of Health and other technical partners at policy, strategy and implementation levels. 

“I think cooperating is the key to our fight against malaria in Uganda,” said Ketty.