Community-Based Intermittent Preventive Treatment Efficacy in Pregnant Women Across Sub-Saharan African Settings

Kungu Erisa

Faculty of Pharmacy Kampala International University Uganda

Email: erisa.kungu@studwc.kiu.ac.ug

ABSTRACT

Malaria during pregnancy posed substantial risks to maternal and fetal health in sub-Saharan Africa, contributing to maternal anemia, placental parasitemia, low birth weight, and neonatal mortality. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine represented a cornerstone intervention recommended by the World Health Organization for malaria-endemic regions. Community-based delivery of this intervention extended coverage beyond facility-based antenatal care, potentially reaching underserved populations with limited healthcare access. This review evaluated the efficacy of community-based intermittent preventive treatment compared to facility-based delivery and examined factors influencing effectiveness across diverse sub-Saharan African settings. A comprehensive synthesis of randomized controlled trials, cohort studies, and implementation research conducted across sub-Saharan Africa over the past fifteen years was performed. Community-based delivery substantially increased coverage of intermittent preventive treatment, particularly among rural and marginalized women, resulting in improved maternal hemoglobin concentrations, reduced placental malaria, and higher mean birth weights. Effectiveness varied by transmission intensity, sulfadoxine-pyrimethamine resistance patterns, HIV prevalence, and quality of community health worker training. Operational challenges included drug supply chain reliability, adherence monitoring, and integration with existing antenatal care systems. Community-based intermittent preventive treatment demonstrated significant efficacy for improving pregnancy outcomes in sub-Saharan Africa, but programmatic success required context-specific adaptation, robust pharmaceutical supply systems, and sustained investment in community health infrastructure.

Keywords: Intermittent preventive treatment, Pregnancy malaria, Community health workers, Sulfadoxine-pyrimethamine, Sub-Saharan Africa.

CITE AS: Kungu Erisa (2026). Community-Based Intermittent Preventive Treatment Efficacy in Pregnant Women Across Sub-Saharan African Settings IAA  Journal of Applied Sciences 14(1):98-104. https://doi.org/10.59298/IAAJAS/2026/14198104