Country | MIP Health System Area | |||||||
Integration | Policy | Commodities | Quality Assurance | Capacity Building | Community Awareness & Involvement | Monitoring & Evaluation | Financing | |
Malawi | Weak collaborationamong MOH, RHU, and NMCP, resulting in disjointedand duplicative MIP programming | MIP policies in line with WHO guidelines but discrepancies across national documents in administration of IPTp | Frequent stockouts of SP and ITNs at ANC clinics hampering uptake of interventions | Limited diagnostic capacity, mistrust of SP efficacy, and irrational use of SP, leading to inconsistent application of clinical guidelines | Capacity-building efforts with current MOH/NMCP and health facility personnel have limited impact in situations of chronic understaffing | Late initiation of ANC (after first trimester), limiting number of IPTp doses administered to pregnant women | Weak HMIS and low provider investment in data management, leading to poor data quality | Government has committed some funds to MIP programs but still relies heavily on donor support |
Score | 2.5 | 3.0 | 2.5 | 2.5 | 3.5 | 3.0 | 3.0 | 2.5 |
Senegal | Joint program planning among NRHP, NMCP, and NACP is low, resulting in duplication of program efforts | MIP policies in line with WHO guidelines, with widespread dissemination to providers | Frequent stockouts of SP and ITNs at ANC clinics hampering uptake of interventions | MIP clinical performance standards developed but low level of supervision due to lack of human resources and logistical and financial constraints | MIP content up-to-date in preservice and in-service educational materials but redundancies in training among NRHP, NMCP, and NACP | Community groups are engaged in promotion of use of ITNs and IPTp; late initiation of ANC (after first trimester), limiting number of IPTp doses administered to pregnant women | Improved data quality through a web-based HMIS; 2 WHO-recommended MIP indicators not tracked | Government has committed some funds to MIP programs, fully funding SP, but still relies heavily on donor support, especially for ITNs |
Score | 3.0 | 4.0 | 2.0 | 2.0 | 3.0 | 3.5 | 4 | 3 |
Zambia | Weak linkages among MOH, RHU, NMCP, and MOH PMTCT Unit limit leveraging of funds and development of holistic MIP package | MIP policies updated in line with WHO guidelines and consistently integrated across national documents | Frequent stockouts of SP and ITNs at ANC clinics hampering uptake of interventions; lack of hemocues limiting hemoglobin testing | Routine, quality supportive supervision for service providers needed to ensure adherence to MIP guidelines | Capacity-building efforts with current MOH/NMCP and health facility personnel have limited impact in situations of chronic understaffing | Late initiation of ANC (after first trimester) limiting number of IPTp doses administered to pregnant women | Inconsistent and inaccurate recording of facility-level data by service delivery providers, leading to poor data quality | Government has committed some funds to MIP programs but still relies heavily on donor support |
Score | 3.0 | 4.0 | 2.0 | 2.0 | 4.0 | 3.0 | 3.0 | 2.0 |
Abbreviations: ANC, antenatal care; HMIS, health management information system; IPTp, intermittent preventive treatment of pregnant women; ITN, insecticide-treated bed net; MIP, malaria in pregnancy; MOH, Ministry of Health; NACP, National AIDS Control Programme; NMCP, National Malaria Control Programme; NRHP, National Reproductive Health Programme; PMTCT, prevention of mother-to-child transmission of HIV; RHU, Reproductive Health Unit; SP, sulfadoxine-pyrimethamine; WHO, World Health Organization.