Malaria in Pregnancy: Service Delivery Assessment at Antenatal Care Facilities in Nasarawa State

Optimal malaria in pregnancy service delivery requires integration of intermittent preventive treatment, insecticide-treated net distribution, and case management within routine antenatal care, yet service delivery quality varies significantly across Nigerian states. This study assessed the quality of malaria in pregnancy service delivery at 20 randomly selected public antenatal care facilities in Nasarawa State, North Central Nigeria. A structured facility assessment checklist aligned with Nigeria's malaria in pregnancy service delivery standards was applied. Exit interviews with 200 antenatal care attendees assessed client experience, net receipt, and intermittent preventive treatment dosage history. Facility assessors documented availability of sulfadoxine-pyrimethamine, insecticide-treated nets, malaria rapid diagnostic tests, and artemisinin-based combination therapy for treatment. Sulfadoxine-pyrimethamine for intermittent preventive treatment was available in 75 percent of facilities, but only 42 percent of eligible women had received two or more doses as recommended. Insecticide-treated net distribution was documented in 60 percent of facilities, though stockouts were reported at two distribution points. Only 35 percent of facilities had malaria rapid diagnostic tests available for symptomatic pregnant women. The study identifies critical supply chain and provider knowledge gaps and recommends targeted facility-level quality improvement interventions. Keywords: malaria in pregnancy, intermittent preventive treatment, antenatal care, Nasarawa State, service delivery.