Background: Malaria in pregnancy remains a major contributor to maternal and infant morbidity and mortality despite scale up in interventions. Its prevention is one of the major interventions in reducing maternal and infant morbidity and mortality. It is known to cause higher rates of miscarriage, intrauterine death, premature delivery, low birth-weight babies, and neonatal deaths. Since pregnant women are most vulnerable to malaria, implementation of the appropriate prevention and control measures among this group is very important. Therefore, the current review was designed to assess the prevalence of malaria among pregnant women in Nigeria. Method: A systematic analysis of recent literature on the prevalence of malaria in pregnancy was carried out and the evidence synthes ized. The databases used were Google Scholar, MEDLINE and PubMed. Search terms used were "prevalence", "malaria", "pregnant women", and "Nigeria". Studies included were cross sectional studies published in different journals on the prevalence of malaria among pregnant women. The total population from the various studies analyzed was two thousand, eight hundred and sixty-six pregnant women between 15 and 45 years. All the women reside in rural and semi-urban areas in Nigeria. Findings: Among the six studies included in this analysis, the estimated pooled prevalence of malaria among pregnant women in Nigeria was 22% in North-Central, 41% in South-East, 26% in South-South, 4.3% in South-West, 41.6% in North-West and 36.74% in North-East. Conclusion: The current review showed that the pooled prevalence of malaria among pregnant women was relatively higher when compared with the prevalence of malaria in the general population. Therefore, the existing prevention and control measures should be strengthened; interventions on malaria prevention and control should focus on behavior change communication.

Nigeria is a country with over 190 million people spread across 36 states including the federal capital territory of the country. Although significant progress has been made towards strengthening the health system, the quality of Water Sanitation and Hygiene (WASH) services that results in Infection Prevention and Control (IPC) advancement efforts are lacking in most Primary Health Care (PHC) facilities in the country. For this reason, there are still gaps in attaining sustainable development goals . This pilot proposal if implemented will bring sustainable and improved WASH services that will improve IPC effort in Primary Health Care facilities. It will address bottleneck issues in leadership and governance and the health workforce which are major health system building blocks. Our target population is about 20 million vulnerable people living in and accessing PHC facilities in South-South, Nigeria. The proposal seeks to bridge the identified system gaps by strengthening leadership, governance, and workforce. This will be achieved by appointing WASH and IPC focal persons from the facilities and communities to improve community participation, accountability, and responsiveness. The pilot program will be scalable to the rest of the country. Liberia and Ethiopia are used as benchmarks references.