Urgent Call to Bridge Policy-Practice Gap in Uganda's Malaria Fight for Pregnant Women

A 20-year-old first-time mother arrived at an antenatal clinic in Uganda at eight months pregnant, gripped by severe fever and vomiting after five days of illness dismissed as normal pregnancy symptoms. Tragically, tests revealed severe malaria and fetal death, a scenario clinicians like Dr. Brian Agaba encounter too often.

Malaria’s patterns are shifting due to climate change, with unseasonal rains, floods, and warmer temperatures fueling unpredictable outbreaks. Uganda bears one of the world’s heaviest burdens, hitting pregnant women and children under five hardest.

Data from the Uganda National Institute of Public Health shows over 2.8 million malaria in pregnancy cases nationwide between 2015 and 2023, with incidence climbing from 15% to 21%. The 2024/25 Uganda Malaria Indicator Survey reports child prevalence rising from 10% in 2018/19 to 13%.

Parasites often lurk undetected in the placenta, disrupting fetal nutrition and oxygen, leading to low birth weight, preterm births, and stillbirths. Up to one in four antenatal attendees test positive, many asymptomatically.

Dr. Agaba, an OB/GYN and Deputy Country Director at Seed Global Health Uganda, calls for three priorities as World Malaria Day approaches on April 25:

1. Close the gap in antenatal and referral care through health worker mentoring, early danger sign recognition, and ending stock-outs of tests, treatments, and nets.

2. Boost public sector hiring and deployment of midwives and nurses to fill staffing voids.

3. Reinforce control measures like child vaccine uptake, net distribution, and diagnostics, backed by climate-adaptive supply chains that preempt shortages.

These steps aim to equip facilities proactively against evolving risks.

Source: Daily Monitor (Uganda)