STUDY SITE The study will be carried out in the Kassena-Nankana district of northern Ghana. The residents are mainly subsistence farmers. There are two main seasons, a short wet season from June to September, during which the transmission of Plasmodium species peaks and a long dry season. The primary resource of the Navrongo Health Research Centre is a district-wide surveillance system, the Navrongo Demographic Surveillance System (NDSS), a longitudinal population registration system that is updated every 90 days. The district has 4 health centres, 3 clinics and a 140-bed hospital that serves as a referral centre. Information collated for the year 2002 in the Kassena-Nankana district indicated that out of an expected 6050 pregnancies, 95% registered for ANC, the average number of visits being 2.7. There were 2173(36%) supervised deliveries, 1279 of these at health facilities and 894 by trained TBAs. 794 out of 2405(33%) pregnant women had haemoglobin levels less than 10g/dl at registration.