The two community - directed approaches will be further developed through workshops with health staff, communities, and resource persons to adapt them to the local situation. Each approach will be implemented in a zone constituted by the catchment area of a number of health centres to cover the required sample size. The zones will be selected in order to avoid contamination between them and randomly assigned to a delivery approach. The main outcomes to be measured are: a) the coverage of IPT (proportion of pregnant women who are administered the treatment), b) the compliance (number of administered doses per pregnant woman), c) the infection prevalence, d) the Hb rate, e) the most relevant difficulties and constraints to each approach, f) the acceptability to population and health staff and g) the performance of each approach to deliver IPT /SP. The sample size is calculated to measure a difference between groups of 10% in IPT administration coverage. Assuming we require 80% power (zβ = 0.84) of detecting a significant difference (P<0.05; zα/2 =1.96) if the intervention increases coverage by 10%, each group should be composed of n = 3841 pregnant women. Assuming a design effect of 1.5, n = 5762 women. The 3 geographical zones will be defined to each cover 5800 expected pregnancies.