1.0 Introduction
1.1 Background of Study
Malaria has a long-standing history in Nigeria and remains one of the most endemic and devastating diseases affecting pregnant women across the country. Historical accounts trace the presence of malaria in Nigeria back to pre-colonial times when communities living near water bodies were already aware of the link between mosquito-infested environments and frequent febrile illnesses. However, scientific understanding of malaria and its transmission began to emerge during the colonial era when Western medicine was introduced (Okwa, 2012).
Malaria is a life-threatening parasitic disease transmitted to humans through the bite of infected female Anopheles mosquitoes. It is caused by Plasmodium parasites, with Plasmodium falciparum being the most prevalent and deadly species in sub-Saharan Africa (WHO, 2023). The disease remains one of the leading public health concerns in Nigeria, accounting for a substantial proportion of hospital visits, admissions, and maternal and child mortality rates. Among vulnerable populations, pregnant women face the highest risk of malaria infection due to physiological changes and a naturally weakened immune system during pregnancy (Desai et al., 2007).
In Nigeria, malaria in pregnancy is a major contributor to poor maternal and neonatal outcomes, including maternal anemia, miscarriage, stillbirth, premature delivery, and low birth weight in newborns. The burden is especially heavy in rural and underserved areas where access to preventive tools, diagnostic services, and timely treatment is limited (FMOH, 2021). Efforts such as the use of insecticide-treated nets (ITNs), intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP), and improved access to antenatal care services have been implemented as control strategies. However, these interventions are often underutilized due to factors such as poor awareness, cultural misconceptions, stock-outs of medications, and weak health infrastructure (Akinleye et al., 2019).
Okwa (2012) asserted that pregnant women in malaria-endemic regions like Nigeria have reduced immunity, making them more susceptible to malaria infection (Okwa, 2012). According to Akinleye et al. (2019), the control of malaria among pregnant women is hindered by several interrelated factors, including lack of access to quality antenatal care, low use of insecticide-treated nets, inadequate uptake of intermittent preventive treatment in pregnancy, and poor awareness of malaria complications. They affirmed that cultural beliefs and misinformation also play a role in discouraging pregnant women from seeking proper malaria prevention or treatment services.
The Nigerian Federal Ministry of Health (FMOH, 2021) reported that although policies and strategies such as the National Malaria Strategic Plan and the free distribution of ITNs have been introduced, implementation gaps persist. These include shortages in essential drugs, inconsistent health worker training, and poor monitoring and evaluation mechanisms. Ezeoke and Onwujekwe (2020) stated that poverty, illiteracy, and inadequate health infrastructure continue to limit the success of malaria interventions, particularly in rural communities where the disease burden remains high. Ojurongbe et al. (2022) reported that despite considerable progress in malaria research and intervention programs, the prevalence of malaria among pregnant women in Nigeria remains disturbingly high, indicating a need for more localized, integrated, and sustainable control strategies. This study is set against the backdrop of these persistent challenges and the urgent need to reduce malaria-related morbidity and mortality among pregnant women in Nigeria.
1.2 Statement of Problems
Investigation revealed that malaria remains one of the most pervasive public health challenges in Nigeria, particularly among pregnant women, who are among the most vulnerable groups. In many rural and urban communities across Nigeria, malaria is still regarded as a routine illness rather than a life-threatening condition, especially during pregnancy when immunity is naturally suppressed. The high prevalence of malaria in pregnant women is associated with several factors, including poor access to quality antenatal care services, and socio-cultural beliefs that discourage the use of insecticide-treated nets (ITNs) and other prophylactic methods.
Additionally, the lack of proper education on the importance of regular malaria screening and adherence to prescribed medications during pregnancy worsens the situation. Pregnant women living in impoverished settings often experience difficulty in accessing healthcare facilities, and where such facilities exist, they are frequently under-resourced and overstretched, making timely diagnosis and treatment a challenge (Okwa, 2012; WHO, 2023).
On the other hand, government efforts through policies such as the National Malaria Elimination Programme (NMEP) have made notable strides in providing preventive tools like ITNs and intermittent preventive treatment in pregnancy (IPTp). However, the effectiveness of these interventions is hindered by weak implementation, inadequate funding, and systemic healthcare challenges.
Furthermore, mismanagement of health education, lack of proper follow-up, and inconsistency in the supply of malaria drugs and test kits reduce the impact of these programs on the target population. It is against this backdrop that this study seeks to investigate the prevalence and control of malaria in pregnant women in Nigeria, with a view to identifying gaps and recommending actionable strategies for improvement.
1.3 Purpose of the Study
The purpose of this study is to examine the prevalence of malaria among pregnant women in Nigeria and assess the effectiveness and challenges of the existing control strategies. The study also seeks to identify socio-demographic, cultural, and environmental factors contributing to malaria infection during pregnancy, with the aim of recommending practical interventions to reduce maternal and fetal morbidity and mortality caused by malaria.
1.4 Aim and Objectives of Study
The aim of the study is to assess the prevalence and evaluate the control of malaria among pregnant women in Nigeria. In achieving this aim, the following specific objectives were laid out as follows:
- To determine the prevalence rate of malaria infection among pregnant women in the selected study area.
- To assess the awareness and use of malaria preventive measures among pregnant women.
- To identify the challenges faced by pregnant women in accessing malaria control services.
- To evaluate the effectiveness of existing malaria control strategies targeted at pregnant women.
1.5 Research Questions
Based on the objectives above, the following research questions will guide the study:
- What is the prevalence rate of malaria among pregnant women in the selected area?
- What level of awareness and usage do pregnant women have regarding malaria preventive measures?
- What are the main challenges affecting pregnant women's access to malaria control services?
- How effective are the existing malaria control strategies in addressing malaria among pregnant women?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant relationship between the control strategies implemented and the prevalence of malaria among pregnant women in the study area
- H1: There is a significant relationship between the control strategies implemented and the prevalence of malaria among pregnant women in the study area
Hypothesis Two
- H0: Awareness and use of malaria preventive measures are not significantly low among pregnant women
- H1: Awareness and use of malaria preventive measures are significantly low among pregnant women
Hypothesis Three
- H0: Pregnant women do not face significant challenges in accessing malaria control services
- H1: Pregnant women face significant challenges in accessing malaria control services
Hypothesis Four
- H0: Existing malaria control strategies are not effectively reducing malaria prevalence in pregnant women
- H1: Existing malaria control strategies are effectively reducing malaria prevalence in pregnant women
1.7 Significance of Study
It is believed that at the completion of the study, the findings will contribute to the growing body of knowledge on maternal health and malaria prevention. This research study will also serve as a guide to healthcare practitioners and policymakers in strengthening malaria control programs.
Additionally, it will promote informed decision-making among pregnant women, their families, and community leaders, thus improving health-seeking behavior and reducing the risks of maternal and neonatal complications associated with malaria.
Furthermore, this research study will serve as a valuable resource for health professionals and caregivers by increasing awareness about the importance of early diagnosis, proper treatment, and consistent malaria prevention during pregnancy.
Lastly, this research study will support healthcare policymakers and public health authorities in designing more responsive and community-specific approaches to malaria prevention and control.
1.8 Scope of Study
This study focuses on pregnant women attending antenatal clinics in selected public health facilities in Kwara State, Nigeria. It examines the prevalence of malaria infection and evaluates the effectiveness of control strategies such as the use of ITNs, IPTp, and access to health education. The study will also assess the factors influencing the uptake of preventive measures among these women.
1.9 Limitations of the Study
A study of this nature is bound to experience certain problems as such the constraints imposed on the research include:
- Time Constraints: A study of this nature needs relatively long time during which information for accurate or at least near accurate inference could be drawn. The period of the study was short, time posed as constraints to the research.
- Financial Constraints: The research would have extended the survey to other area at the empirical level, but limitation as included cost of transportation to the source of material and the cost of time setting of the already completed work.
- Lack of Cooperation: Many of the respondents are usually aggressive on issue that border cooperation among the respondents border.
- Response Bias: The study will involve surveys and interviews with cooperative managers and members. Response bias may occur if respondents provide socially desirable answers or if there is reluctance to disclose negative financial information due to privacy concerns or fear of repercussions.
1.10 Definition of Terms
Malaria: A parasitic disease transmitted by the bite of infected Anopheles mosquitoes, primarily caused by Plasmodium falciparum in Nigeria. It presents with symptoms such as fever, chills, and body weakness, and is particularly dangerous during pregnancy (WHO, 2023).
Pregnant Women: In this context, women who are confirmed to be pregnant and are receiving or expected to receive antenatal care services in healthcare facilities in Nigeria.
Prevalence: The total number of existing cases of malaria among pregnant women in the study area at a given time. It helps to understand the extent and magnitude of malaria burden (CDC, 2022).
Control Measures: Strategies and interventions designed to prevent and reduce the spread of malaria. These include the use of insecticide-treated nets, indoor residual spraying, intermittent preventive treatment (IPTp), and public health education.
IPTp(Intermittent Preventive Treatment in Pregnancy): A malaria prevention approach where pregnant womenare given antimalarial medication (such as sulfadoxine-pyrimethamine) atscheduled intervals during pregnancy, even if they are not showing symptoms(FMOH, 2021).
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