Project – Assessing the impact of malaria on maternal and child health

CHAPTER ONE

INTRODUCTION

• Background to the Study

Malaria remains a significant public health concern, particularly in sub-Saharan Africa where it disproportionately affects pregnant women and children under five. The World Health Organization (2023) emphasizes that pregnant women are at heightened risk due to physiological changes that increase their susceptibility to malaria infection. The parasitic disease has been linked to adverse maternal outcomes such as anemia, miscarriage, stillbirth, and maternal death. Studies have consistently shown that Plasmodium falciparum, the most severe malaria parasite, is a major contributor to poor pregnancy outcomes, especially in regions with intense malaria transmission (Desai et al., 2007).

The impact of malaria on maternal health is also reflected in the high prevalence of maternal anemia, which is often associated with placental malaria. According to Guyatt and Snow (2004), placental malaria leads to the sequestration of infected erythrocytes in the placenta, impairing nutrient and oxygen transport to the fetus and increasing the risk of maternal anemia and delivery complications. In addition, research by Rogerson et al. (2007) indicates that women in their first and second pregnancies are more susceptible to placental malaria due to lack of immunity, further exacerbating risks to both mother and child.

For children, malaria is a leading cause of morbidity and mortality. Intrauterine exposure to malaria can lead to low birth weight (LBW), a significant risk factor for neonatal and infant death. Studies by Steketee et al. (2001) show that infants born to mothers with malaria are more likely to suffer from LBW, preterm delivery, and impaired growth. Furthermore, newborns and infants are at an increased risk of severe malaria due to their immature immune systems and potential maternal transmission of the parasite during gestation.

Malaria during pregnancy not only affects health outcomes but also influences the utilization of maternal and child healthcare services. Research by Hill et al. (2006) has shown that fear of malaria and associated health costs can discourage pregnant women from attending antenatal clinics, where they would otherwise receive preventive interventions such as intermittent preventive treatment in pregnancy (IPTp) and insecticide-treated nets (ITNs). This reduction in healthcare-seeking behavior compounds the problem by delaying diagnosis and treatment.

Intervention strategies aimed at mitigating the impact of malaria on maternal and child health have shown mixed success. According to the WHO (2022), the use of IPTp with sulfadoxine-pyrimethamine and ITNs has significantly reduced the incidence of malaria in pregnancy and improved birth outcomes. However, access and adherence to these interventions remain a challenge, especially in rural and underserved areas. Additionally, resistance to antimalarial drugs threatens the effectiveness of current preventive and treatment protocols (White, 2004).

In summary, malaria poses a critical threat to maternal and child health, influencing outcomes such as maternal anemia, low birth weight, and infant mortality. The literature highlights the importance of comprehensive malaria prevention strategies during pregnancy, improved access to healthcare services, and the continuous monitoring of drug resistance patterns. Addressing these challenges is vital to achieving Sustainable Development Goals (SDGs) related to maternal and child health in malaria-endemic regions.

1.2. Statement of the Problem

Malaria continues to be a significant global health issue, with over 240 million cases and approximately 600,000 deaths reported annually, the majority occurring in sub-Saharan Africa (WHO, 2023). Among the most vulnerable populations are pregnant women and young children, who suffer disproportionately from the consequences of malaria infection. Despite global efforts to reduce the burden of the disease, malaria remains a major contributor to maternal and child morbidity and mortality. The disease’s persistence in many low-income and rural communities poses a severe threat to the health and survival of mothers and their children.

In pregnant women, malaria is associated with numerous adverse health outcomes, including maternal anemia, miscarriage, premature birth, and increased risk of death. These complications are more pronounced among first-time mothers and those with limited access to antenatal care. Yet, in many endemic regions, access to malaria preventive interventions such as intermittent preventive treatment in pregnancy (IPTp) and insecticide-treated nets (ITNs) is still limited or underutilized. This gap in prevention coverage continues to expose pregnant women to high levels of risk, especially in communities with poor health infrastructure.

For children, especially those under the age of five, malaria is a leading cause of illness and death. Infants born to mothers who had malaria during pregnancy are often underweight, preterm, or immunologically compromised. These children are more likely to suffer severe malaria infections and are less likely to survive early childhood. Despite this, there is limited integration of maternal and child health programs with malaria control strategies, leading to fragmented service delivery and suboptimal outcomes for both mother and child.

Another problem lies in the socio-economic factors that exacerbate malaria’s impact. Poverty, illiteracy, and gender inequality limit women’s ability to access healthcare services and protective interventions. In many rural communities, cultural beliefs and misconceptions about malaria further discourage the use of preventive measures during pregnancy. This results in late presentation to health facilities, incomplete treatment, and higher rates of complications. Without targeted interventions that address these social barriers, efforts to reduce the burden of malaria among mothers and children are unlikely to succeed.

There is also a critical need for more localized and up-to-date research on the link between malaria and maternal-child health outcomes. While global statistics highlight the general impact of malaria, specific data on how the disease affects different regions, communities, and population groups is often lacking. This data gap impedes the development of tailored interventions and limits the ability of policymakers and healthcare providers to effectively allocate resources and plan targeted programs.

In light of these challenges, there is an urgent need to assess the impact of malaria on maternal and child health through comprehensive and context-specific research. Such assessment is essential for informing health policies, improving maternal and child health services, and guiding the allocation of resources toward effective malaria control. Understanding the full extent of malaria’s impact will support the design of integrated and sustainable interventions that address the health needs of vulnerable populations and contribute to achieving global health goals.

1.3. Aim and Objectives of the Study

The aim of the study is assessing the impact of malaria on maternal and child health in Dekina Local Government Area of Kogi State, Nigeria. The specific objectives are:

1. To assess the prevalence of malaria among pregnant women and children in the study population.
2. To determine the impact of malaria on maternal and child morbidity and mortality rates.
3. To evaluate the effectiveness of current malaria prevention and treatment strategies in reducing the burden on maternal and child health.
4. To identify socio-economic and environmental factors that contribute to the spread of malaria in the community.

1.4. Research Questions

The research questions are buttressed below:

1. What is the prevalence of malaria among pregnant women and children in the study population?
2. How does malaria impact maternal and child morbidity and mortality rates?
3. What is the effectiveness of current malaria prevention and treatment strategies in reducing the burden on maternal and child health?
4. What socio-economic and environmental factors contribute to the spread of malaria in the community?

1.5. Research Hypothesis

The hypothetical statement of the study is stated below:

Ho: Malaria has no significant impact on maternal and child morbidity and mortality rates.

H1: Malaria has significant impact on maternal and child morbidity and mortality rates.

1.6. Significance of the Study

This study is significant because it contributes to a deeper understanding of how malaria affects two of the most vulnerable population groups—pregnant women and young children. By examining the extent and nature of the impact of malaria on maternal and child health, this research provides critical insights into the health risks faced by millions of women and children in malaria-endemic regions. Such understanding is crucial in identifying the gaps in current interventions and proposing solutions that are evidence-based and context-specific.

The findings from this study will benefit public health policymakers by offering data that can inform the design and implementation of targeted malaria control strategies. Specifically, the study will help in prioritizing interventions that address the unique needs of pregnant women and children. It can guide resource allocation toward programs that integrate malaria prevention with maternal and child health services, improving the overall efficiency and effectiveness of public health responses.

For healthcare providers and professionals, this study offers valuable information on the clinical and epidemiological links between malaria and adverse maternal and child health outcomes. This knowledge can support improved clinical decision-making, more effective patient education, and better management of malaria in pregnancy and infancy. By identifying patterns in disease presentation and outcomes, health practitioners will be better equipped to intervene early and reduce the burden of complications.

This study also holds significance for researchers and academics by filling knowledge gaps in existing literature. While malaria has been widely studied, specific analyses focused on its combined impact on maternal and child health, especially within localized or underserved communities, remain limited. The study’s findings can serve as a basis for future research, policy evaluations, and programmatic interventions that aim to reduce malaria-related morbidity and mortality.

At the community level, the study’s outcomes could help raise awareness about the dangers of malaria during pregnancy and early childhood. Increased knowledge can empower women, families, and local leaders to take preventive actions, such as using insecticide-treated nets, seeking antenatal care early, and ensuring prompt treatment for malaria symptoms. This empowerment is essential for driving behavior change and improving the uptake of malaria-related health services.

Finally, this study contributes to the broader global health agenda, particularly the Sustainable Development Goals (SDGs), which aim to reduce maternal and child mortality and combat communicable diseases such as malaria. By producing evidence to support targeted, integrated health interventions, this research aligns with international efforts to promote health equity and improve outcomes for marginalized populations. Its findings may therefore be valuable not only nationally or regionally but also to the global health community.

1.7. Scope of the Study

The study assesses the impact of malaria on maternal and child health in Dekina Local Government Area of Kogi State, Nigeria. The study is limited to Nursing mothers attending clinic the Dekina Local Government Area of Kogi State, Nigeria

1.8.  Operational Definition of Terms

Impact: In public health, impact refers to the measurable and significant effect or influence that a condition, policy, or intervention has on health outcomes. In this context, it refers to how malaria affects the health and well-being of mothers and children—such as causing illness, death, or long-term complications.

Malaria: Malaria is a life-threatening disease caused by parasites of the genus Plasmodium, transmitted to humans through the bites of infected female Anopheles mosquitoes. The most severe form is caused by Plasmodium falciparum. Malaria symptoms include fever, chills, headache, and in severe cases, anemia, organ failure, or death—especially in vulnerable groups like pregnant women and children.

Health: Health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity (World Health Organization, 1948). In this study, it refers to the overall condition and functioning of mothers and children in relation to malaria infection and its consequences.

Maternal: Maternal refers to anything related to a woman during pregnancy, childbirth, and the postpartum period. Maternal health specifically focuses on the health of women during these stages, including their physical and emotional well-being, risk of complications, and access to healthcare.

Child Health: Child health refers to the physical, emotional, and developmental well-being of children from birth through adolescence. It includes factors like nutrition, immunity, disease prevention, and access to healthcare. In the context of malaria, child health includes how the disease affects growth, survival, and overall development.

Project – Assessing the impact of malaria on maternal and child health