Date Published: April 10, 2007
Publisher: Public Library of Science
Author(s): Joan Muela Ribera, Susanna Hausmann-Muela, Umberto D’Alessandro, Koen Peeters Grietens
Abstract: Building on existing knowledge from social science work on malaria, the authors propose two models for studying social science aspects of malaria in pregnancy.
Partial Text: Social science literature on malaria and its control is abundant. However, nearly all the publications focus on children under the age of five. Even in gender-oriented literature, women are depicted as “mothers and caretakers of children” rather than as women suffering from malaria. The specific topic of malaria in pregnancy has received little attention in social science literature, with only some 20 articles explicitly integrating social science aspects [1–3].
We propose two models for studying the social science aspects of malaria in pregnancy: the “Malaria in Pregnancy Treatment Model” and the “Malaria in Pregnancy Prevention Model” (see Figures 1 and 2). These models are a conglomerate of different psycho-social and socio-behavioural models, based on our own field research experience and on a literature review. We believe that these adapted models comprehensively and holistically describe the most relevant factors involved in malaria and pregnancy.
Prevention with IPT represents an intervention that encompasses two levels: the administration of IPT and the structure of antenatal care (Figure 2). For the IPT part, the above mentioned factors 1–7 practically remain unaltered and are not repeated here. There are only a few alterations with regard to antimalarials used as a preventive rather than treatment measure.
The great difference of the prevention model when compared to the treatment model is the overlapping of ANC utilisation and IPT acceptance and the probability of interaction between both sets of variables.
We have proposed two models which encompass the different social factors that influence health-seeking behaviour for malaria in pregnant women and demonstrate how they are related to each other. Together with quantitative analysis, which evaluates the relative occurrence of the different factors and ranks them according to their frequency, qualitative analysis is incorporated to contextualise the factors, put them into a dynamic relation, and assess their relative weight and importance within the general social structure. We have developed these models for malaria in pregnancy because it is in this field that social sciences are particularly neglected. Research on and implementation of malaria control intervention for pregnant women have predominantly ignored community responses or, when considered, they have centred on single, isolated factors usually with the aim of designing “culturally sensitive” information, education, and communication messages. Reality, however, shows that the implementation of “simple” tools, like IPT delivery to pregnant women, is not so simple because community reactions are not taken into account.