Control measures for malaria in pregnancy in India.

The purpose of this paper is to examine the current status of malaria in pregnancy (MiP) in India and review current control measures, programmes and interventions that work, and to suggest areas that need to be addressed. MiP can have serious health consequences for both the mother and infant, and thus presents a major public health challenge. Roll Back Malaria (RBM), a supporting agency of the World Health Organization (WHO), recommends reducing the burden of MiP through the following control measures: insecticide treated nets (ITNs), intermittent preventive therapy (IPTp), and effective case management. Even though India has a comprehensive national malaria programme, specific control measures aimed at decreasing the burden of MiP are limited in availability or are not adequately available. Components of the national malaria programme, which may serve to alleviate the MiP burden include the integration of malaria control with general health services and use of indoor residual spraying (IRS). These control strategies are beneficial because they reduce overall malaria exposure, both for pregnant women and the general population. However, there are several challenges and issues that India still faces regarding MiP. Major among them are the lack of ITNs, socio-cultural issues, growing resistance to antimalarials and insecticides, a new, yet to be fully implemented drug policy, and a highly centralized malaria control programme. A review of the current control measures for MiP in India indicates that these challenges and issues must be addressed in order to alleviate the MiP situation in India.