Malaria is the leading cause of illness and death in Papua New Guinea (PNG). Infection during pregnancy with
falciparum or vivax malaria, as occurs in PNG, has health implications for mother and child, causing complications such as
maternal anemia, low birth weight and miscarriage. This article explores knowledge, attitudes and practices concerning malaria
during pregnancy and it’s prevention in Madang, PNG, a high prevalence area.
As part of a qualitative
study in Madang, exploring MiP, participatory techniques (free-listing and sorting) were conducted along with focus group
discussions, in-depth interviews (with pregnant women, health staff and other community members) and observations in the local
community and health facilities.
The main themes explored were attitudes towards and knowledge of MiP,
its risks, and prevention. Although there was a general awareness of the term "malaria", it was often conflated with general
sickness or with pregnancy-related symptoms. Moreover, many preventive methods for MiP were related to practices of general
healthy living. Indeed, varied messages from health staff about the risks of MiP were observed. In addition to ideas about
the seriousness and risk of MiP, other factors influenced the uptake of interventions: availability and perceived comfort
of sleeping under insecticide-treated mosquito nets were important determinants of usage, and women’s heavy workload influenced
The non-specific symptoms of MiP and its resultant conflation with symptoms
of pregnancy that are perceived as normal have implications for MiP prevention and control. However, in Madang, PNG, this
was compounded by the inadequacy of health staff’s message about MiP.