Barriers in managing maternal schistosomiasis: a qualitative study of healthcare providers in Tanzania

Abstract

BACKGROUND: Maternal schistosomiasis threatens the health of pregnant women and their foetuses in endemic regions. Although praziquantel is recommended for treatment, its utilization remains low. This study explored the experiences of healthcare providers (HCPs) with schistosomiasis, particularly maternal schistosomiasis, and their perceived management barriers in Tanzania. METHODS: This qualitative case study was conducted in October 2024 with nine purposefully selected HCPs. In-depth interviews guided by a semi-structured tool analysed HCPs' experiences with schistosomiasis, maternal schistosomiasis and perceived management barriers. Interviews were audio recorded, transcribed verbatim and thematically analysed to identify key insights and barriers. RESULTS: Barriers to maternal schistosomiasis management were identified across three levels. At the policy level, the absence of guidance on diagnosis, treatment and prophylaxis in maternal health guidelines, along with the exclusion of pregnant women from mass drug administration programs, were prominent. Health system barriers included limited knowledge and training among HCPs and concerns about praziquantel safety in pregnancy. At the community level, inadequate health education, misconceptions, reliance on drug outlets and negative perceptions of praziquantel further impeded effective management. CONCLUSIONS: Maternal schistosomiasis management in Tanzania is hindered by policy gaps, limited HCP training and community misconceptions. Integrating care into antenatal services, updating guidelines and strengthening community education are essential in endemic settings.