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Community-informed research on malaria in pregnancy in
                Monrovia, Liberia: a grounded theory study

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Background: Liberia is a West African country that needs substantial investment to strengthen its National Malaria
Control Programme (NMCP), which was disrupted during the 2014–2016 Ebola epidemic. As elsewhere, Liberian
pregnant women are especially vulnerable to malaria. Understanding prevention and treatment-seeking behaviours
among the population is crucial to strategize context-specifc and women-centred actions, including locally-led
malaria research, to improve women’s demand, access and use of NMCP strategies against malaria in pregnancy.
Methods: In 2016, after the Ebola crisis, a qualitative inquiry was conducted in Monrovia to explore populations’
insights on the aetiology, prevention and therapeutics of malaria, as well as the community and health workers’
perceptions on the utility of malaria research for pregnant women. In-depth interviews and focus group discussions
were conducted among pregnant women, traditional community representatives and hospital staf (n=38), using a
feminist interpretation of grounded theory.
Results: The narratives indicate that some Liberians believed in elements other than mosquito bites as causes
of malaria; many had a low malaria risk perception and disliked current efective prevention methods, such as
insecticide-treated nets; and some would resort to traditional medicine and spiritual care to cure malaria. Access to
clinic-based malaria care for pregnant women was reportedly hindered by lack of fnancial means, by unofcial user
fees requested by healthcare workers, and by male partners’ preference for traditional medicine. The participants
suggested that malaria research in Liberia could help to design evidence-based education to change current malaria
prevention, diagnostic and treatment-seeking attitudes, and to develop more acceptable prevention technologies.
Conclusion: Poverty, insufcient education on malaria, corruption, and poor trust in healthcare establishment are
structural factors that may play a greater role than local traditional beliefs in deterring Liberians from seeking, access‑
ing and using government-endorsed malaria control strategies. To increase access to and uptake of preventive and
biomedical care by pregnant women, future malaria research must be informed by people’s expressed needs and
constructed meanings and values on health, ill health and healthcare.

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Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Community-informed research on malaria in pregnancy in
                Monrovia, Liberia: a grounded theory study