The research will be implemented in Burkina Faso. Malaria is endemic with seasonal transmission and is responsible for considerable ill health among pregnant women. The study site will be situated in the rural area of the Pissy health district which covers both the western peri-urban zone of Ouagadougou city and adjacent rural areas. There are a total of 25 health facilities in the district (both rural and urban) and a reference hospital at Ouagadougou. In 2004 the population of the district was approx. 542000 inhabitants. The estimated number of pregnancies was 27000. There is generally low attendance for antenatal care (ANC) and 15% of babies are born with LBW. In a study carried out in the Boromo rural district, only 51% of pregnant women had 2 ANC visits before delivery (Coulibaly, personal communication). HIV infection prevalence was found around 4% for the whole country (MoH, 2005) and there is no indication that it is different for the Pissy district catchment area.