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Women & Malaria: A Conversation with Wani K. Lahai, Malaria in Pregnancy Focal Point at Sierra Leone’s National Malaria Control Program

Women are at the forefront in the fight against malaria. From community health workers to heads of state, they are working across the globe to save millions of lives each year.

PMI Impact Malaria recently caught up with Wani K. Lahai from the Sierra Leone National Malaria Control Program (NMCP) to discuss malaria in her country and the role that women play in delivering malaria services.

Sierra Leone’s entire population of about 7.6 million people is at risk of malaria. Young children and pregnant women are particularly vulnerable. Each year, more than 2 million outpatient visits due to malaria are reported in the country, half of which are children under the age of five. As the flagship malaria service delivery project of the U.S. President’s Malaria Initiative, PMI Impact Malaria supports the NMCP to strengthen health care provider skills to prevent and respond to malaria in pregnancy (MIP) and enhance the country’s ability to collect and use data for decision-making.

As the MIP focal point for the NMCP, Wani leads MIP efforts and trains health providers across the country to provide quality pre-natal care to moms-to-be, including preventing malaria. She shared her insights gained after years in the field:

Women must be involved at every stage of the malaria service delivery process

The NMCP recently developed a 4-year strategic plan to combat malaria in Sierra Leone. As part of the process, Wani and her colleagues analyzed the strengths and weaknesses of their previous programming. They identified gender as playing a large role in malaria service delivery and chose to include it as one of the social values of the new plan.

“Gender was factored into our new strategic plan to ensure that women play a vital role not only in delivering services in workplaces, but also to make sure that they take the lead in research,” says Wani. When women conduct research, their different experiences and backgrounds may make them more familiar with issues and how best to address them. The NMCP also plans to disaggregate data by gender, which will allow them to make more informed decisions.

Lack of decision-making power affects all sides of malaria service delivery

Women face obstacles both delivering malaria services and receiving them. Female health workers often battle entrenched gender dynamics while delivering health services. “When they are with their male counterparts, they are marginalized” says Wani, “they have no say in the communities, so men make the decisions.”

The very lack of decision-making power that can hinder female health workers also affects women seeking malaria care. “When a pregnant woman in the community goes to a health facility for antenatal care, she has to seek permission from her husband,” says Wani. It is during antenatal care, or pre-natal check-ups, that pregnant women receive antimalarial drugs and insecticide-treated nets to stay malaria-free during pregnancy. However, having to seek permission means many women only attend pre-natal check-ups later in their pregnancies, arriving too late to receive a full course of antimalarials, and many do not attend all four recommended check-ups.

Passion is key to a job well done

Wani began her career as a State Registered Nurse and State Certified Midwife. Interested in maternal and child health issues, she spent several years working at health facilities and District Health Management Teams across the country, including at internally displaced persons camps during the Sierra Leone civil war.

Wani rose through the ranks and was appointed as the MIP focal point at the NMCP. She attributes her success to her passion and hard work. “You need passion, you need empathy. I want to do a quality job and go the extra mile. Even when I’m off duty, sometimes people call me after official work hours and I respond,” says Wani “I love working on malaria issues. This is where God wants me to be.”

Wani facilitates a training for health workers on the prevention and control of malaria during pregnancy in Waterloo, Western Area Rural District, Sierra Leone. Photo Credit: William Pessima, National Facilitator/MIP Technical Working Group Member, Sierra Leone

As one of few women in senior health positions in the country, Wani advocates for empowering women and recognizing their role in the fight against malaria. “You educate a woman, you educate a nation,” says Wani.

Header Photo Caption: Women attending their antenatal care (ANC) visits at Gboma Sama Community Health Post in Port Loko, Sierra Leone. Photo Credit: Keith Esch, PMI Impact Malaria

Written by Katherine Kemp, PMI Impact Malaria Communications Coordinator. Editorial contributions from Lorina McAdam and Mary Warsh, PMI Impact Malaria Deputy Project Director.

PMI Impact Malaria is funded and technically assisted by the U.S. President's Malaria Initiative (PMI) and led by Population Services International (PSI) in partnership with JhpiegoMedical Care Development International (MCDI), and the Malaria Elimination Initiative (MEI) at UC San Francisco.

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