title: Knowledge, attitudes, and practices concerning malaria in pregnancy: results from a qualitative study in Madang, Papua New Guinea.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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 Chloroquine adherence.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain; Bridge HIV, San Francisco Department of Public Health, San Francisco, California, United States of America.
authors.forename: Erin V W
authors.initials: EV
authors.lastname: Andrew
authors.affiliation: Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain; Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Christopher
authors.initials: C
authors.lastname: Pell
authors.affiliation: Papua New Guinea Institute of Medical Research, Madang, MP 511, Papua New Guinea.
authors.forename: Angeline
authors.initials: A
authors.lastname: Angwin
authors.affiliation: Papua New Guinea Institute of Medical Research, Madang, MP 511, Papua New Guinea.
authors.forename: Alma
authors.initials: A
authors.lastname: Auwun
authors.affiliation: Papua New Guinea Institute of Medical Research, Madang, MP 511, Papua New Guinea.
authors.forename: Job
authors.initials: J
authors.lastname: Daniels
authors.affiliation: Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain; Papua New Guinea Institute of Medical Research, Madang, MP 511, Papua New Guinea; Infection & Immunity Division, Walter & Eliza Hall Institute, 1G Royal Parade Parkville, VIC, Australia.
authors.forename: Ivo
authors.initials: I
authors.lastname: Mueller
authors.affiliation: Papua New Guinea Institute of Medical Research, Madang, MP 511, Papua New Guinea.
authors.forename: Suparat
authors.initials: S
authors.lastname: Phuanukoonnon
authors.affiliation: Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain; Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Robert
authors.initials: R
authors.lastname: Pool
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use; D002738:Chloroquine / Q000627:therapeutic use; D005260:Female; D017144:Focus Groups / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D057148:Insecticide-Treated Bednets / Q000706:statistics & numerical data; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology*; D016780:Malaria, Vivax / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology*; D010219:Papua New Guinea / Q000453:epidemiology; D010349:Patient Compliance / Q000523:psychology*; D010963:Plasmodium falciparum / Q000187:drug effects / Q000502:physiology; D010966:Plasmodium vivax / Q000187:drug effects / Q000502:physiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology*; D036301:Qualitative Research; D011795:Surveys and Questionnaires
chemical_list: D000962:Antimalarials; D002738:Chloroquine