Association between malaria prophylaxis stock-outs, and birth and maternal outcomes in Zimbabwe

Approximately three hundred thousand mothers and sixty-seven percent of children die from preventable and treatable diseases globally despite rapid developments in medicines over the years. Pregnant women, neonates and children under five are particularly vulnerable to malaria and bear the burden of malaria infections. Understanding the preventive efforts against malaria is therefore crucial. This paper investigates the association between malaria prophylaxis stock-outs and birth and maternal health outcomes in Zimbabwe. Combining the administrative data on stock-outs of malaria prophylaxis and 2015 nationally representative Demographic Health Survey data, we examine malaria prophylaxis stock-outs and birth and maternal health outcomes. Malaria prophylaxis stock-outs are prevalent and increasing over time in Zimbabwe. We also note regional disparities in malaria prophylaxis stock-outs, where stock-outs are more prevalent in some districts than others. Using pooled OLS, malaria prophylaxis stock-outs are significantly associated with birth weight. Drug stock-outs are, therefore, associated with compromised birth health outcomes while significantly associated with only haemoglobin levels for urban women. Malaria prophylaxis stock-outs significantly push neonates with average birth weights towards the lower end of normal birth weight, hence increasing developmental disabilities in these neonates. In addition, drug stock-outs are insignificantly associated with childunderweight, stunting and wasting. We recommend that policymakers invest in pharmaceutical information systems and stock ordering systems to prioritise the prevention of malaria and improve maternal and birth outcomes as proposed by the Sustainable Development Goals. This improves drug availability in areas where they are most needed.