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Project components

Intervention trial

At the core of the project is the Intervention study that will assess whether the implementation of monthly screening of pregnant women with rapid diagnostic tests for malaria in the community by community health workers, on top of the standard antenatal care package, will improve maternal and infant outcome related to malaria in pregnancy.
This will be established by carrying out a multi-country cluster-randomized, community-based trial in which the community health worker will be the key player. The study will be implemented in three West African countries (Benin, Burkina Faso and The Gambia) with varying degrees of malaria transmission intensity (high in Burkina Faso and Benin and low in The Gambia) and the varying  resistance rates against the drug that is used as a preventive treatment, sulfadoxine-pyrimethamine (high in The Gambia and Benin and low in Burkina Faso).
The trial is complemented by research activities that will help establish whether the new intervention can be successfully integrated within the existing health system, whether it is acceptable to the population and the health staff, and if it is cost-effective.
Health system research
The overall effect of implementing the new interventions on the existing health system will be assessed, with particular focus on the perception and motivation of the local health workers. Possible bottlenecks for the implementation of the intervention by the Community health workers will also be identified.
Social science
The social science group will investigate the acceptability of the new intervention, adherence to treatment and possible structural barriers to health care. It will also evaluate how the intervention may change pregnant women’s perception of antenatal care in general and the existing preventive measures such as IPTp and bed nets  in particular.
Health economics
Health economics will evaluate the direct and indirect costs and benefits of allocating scarce resources to a new intervention. An economic evaluation will be conducted to identify the extra costs and benefits of the new intervention to health care providers and the households.
Dissemination and policy-making
The results will be compiled into a comprehensive programme of dissemination to policy-makers, including the National Malaria Control Programmes of the countries involved and in the region. Essential in reaching the project objectives is the endorsement of the interventions by local, national and international stakeholders. Therefore, the project will have the stakeholders involved from the start of the project through frequent policy panels and policy briefs.