Table 4 Qualitative Findings from IDIs with Healthcare Providers

Knowledge of malaria, MiP and IPTp-SP

“The bit I know about malaria is that malaria is a disease which is caused by mosquito specifically the female anopheles mosquito and usually pertaining to pregnant women it becomes very serious because now we are dealing with two lives. If malaria is not treated well it can cause preterm labour, it can also abort the baby and also put the mother’s life in danger.” (IDI, Midwife, 04)

“I learnt that, it can cause preterm labour. Yes, when malaria sets in preterm labour can be caused, like the symptoms of malaria, the pregnant woman will have it but in relation to pregnancy it’s a very risky something for pregnant women. It can cause premature labour.” (IDI, Midwife, 02)

“So the drug of choice is Sulfadoxine-Pyrimethamine. After 16 weeks of pregnancy or after quickening that’s when we start to give the malaria drug. So it comes in three doses, you take it. Urm so I’ll say the time interval is 1 month after the first dose, so it’s just 1 month 1 month interval after the first dose” (IDI, Midwife, 01)

“With the guidelines, I don’t know whether they’ve revised it. The first thing that I know we do is we look at the G6PD status then afterwards we look at the gestational age. Depending on when they first feel the baby’s movement that’s when they can start…. But those who have already given birth feel the fetal movement earlier around 16 weeks and they start taking their SP and it’s 4 weeks interval with each dosage.” (IDI, Midwife, 04)

Practice of Directly Observed Therapy

“Oh it’s oral, when we give it [SP] to them [pregnant women] they will not take it [SP] so we tell them to get their water we put it [SP] in their hand and they take it orally. We [midwives] observe them as they take it.” (IDI, Midwife, 02)

“We don’t give it to them [pregnant women] to send it home. You bring the water and the midwife gives the tablet [SP] to you to take it in front of her.” (IDI, Midwife, 03)

“Some of them they’ll [pregnant women] say they have reactions when they take it [SP], they feel dizzy, they have body pains so they don’t want to take it.” (IDI, Midwife, 01)

Education of pregnant women

“We’ve been telling them things that will happen if they do not take the drug. Even if it escapes us to give it to them they remind us to do so.” (IDI, Midwife, 03)

“…those who come early and the education is well gotten that helps us when we’re giving the medication. And even some of the clients are even able to testify to aid our education and how the SP is able to help them, how they’ve seen someone who didn’t take their SP well and the end results of it.” (IDI, Midwife, 04)

Training of healthcare providers

“Like I said, I am just starting the work so I’ve not had the opportunity to attend any workshop and since I started working here too they haven’t organized any workshop here. So maybe as time goes on” (IDI, Midwife, 02)

“Yes, we did an in-service training here once and I joined.” (IDI, Midwife, 04)