Anthropological studies on malaria in pregnancy

A nurse vaccinates a baby outside her home near San Pablo, NicaraguaProject Coordinator: Robert Pool (Spain)

Principal Collaborators:

Spain: Arantza Meñaca, Christopher Pell, Erin V. W. Andrew (CRESIB, Spain)

Ghana : Harry Tagbor, Nana A. Boateng (KNUST, Kumasi, Ghana) and Abraham Hodgson, Samuel Chatio (NHRC, Navrongo Ghana)

Kenya: Peter Ouma, Florence Achieng (KEMRI-CDC, Kisumu, Kenya)

PNG:  Suparat Phuanukoonnon, Alma Auwun, Angeline Angwin (IMR, PNG)

New interventions to reduce malaria in pregnancy can only be considered completely effective if – in addition to being efficacious, safe and affordable – they are socially and culturally acceptable, are widely adhered to in the longer-term, and do not negatively affect attitudes and adherence to existing public health measures.
Anthropological studies are being carried out to address these issues in various sites in Africa and Papua New Guinea. In particular, these studies focus on:

  • Local perceptions, experiences and behaviour relating to pregnancy, illness, and in particular malaria in pregnancy.
  • Acceptability of new interventions for malaria in pregnancy.
  • Patterns of use of existing malaria interventions and other health resources by pregnant women in order to identify ways in which new interventions can be linked to existing ones in ways that maximise the acceptability of both.
  • Broader social and cultural factors that (could) affect interventions for malaria in pregnancy at facility, district, and national level

The general approach and design of this study is anthropological. This entails generating an understanding of acceptability and adherence by relating them to:

  • Culture: shared ideas, conceptual models and meanings that underlie the ways in which people think and behave;
  • Praxis: what people actually do in practical situations – the improvisation and innovation that deviates from what they say they think and believe and do);
  • Context: the broader context of social, cultural and historical processes that constrain and influence both beliefs and practical behaviour;
  • Comparing: similar phenomena in different settings to enable a distinction between local context-specific influences and more general regional and global influences.

Data is being collected using a combination of quantitative and qualitative methods, including direct observation, case studies, structured and open in-depth interviews, focus group discussions and content analysis of relevant media coverage and policy documents. Data will be compared and triangulated to increase the reliability and validity of the qualitative data and to generate a more detailed and comprehensive understanding.