Meanings of malaria among pregnant women in an endemic area of Colombia

Abstract

Introduction: In Colombia, research on gestational malaria is scarce and focuses on quantitative studies that do not include the lived experiences of affected pregnant women.

Objective: To describe the meanings of gestational malaria among pregnant women inhabiting in areas endemic to the disease in northwestern Colombia (departments of Córdoba and Antioquia) in 2023-2024.

Methods: An ethnographic study involving 46 pregnant women recruited through prenatal care programs. Data collection methods included semi-structured interviews, focus groups, participant and non-participant observation, and field diaries. Analysis involved category saturation, methodological and investigative triangulation, emic-etic contrast, and hermeneutic analysis. Rigor criteria regarding credibility and confirmability were applied.

Results: The meanings attributed to gestational malaria are linked to misconceptions about the disease, limited knowledge regarding the consequences of malaria during pregnancy for maternal-fetal health, and infrequent preventive practices. These meanings are shaped by the cultural, familial, and personal significance attached to motherhood and pregnancy, limitations in prenatal care, and a reliance on traditional care practices, driven by multiple economic and geographic barriers to hospital access.

Conclusions: The qualitative evidence generated in this study expands upon traditional explanations of the disease; allows for the tailoring of programs to specific sociocultural contexts; highlights the importance of understanding the experiences of those affected to grasp the complexity of addressing gestational malaria; and identifies dimensions of the disease, acting as social determinants, that are currently excluded from control measures but must be addressed to ensure efficient, equitable, and socioculturally valid outcomes.