Cross sectional surveys will be carried out at the beginning, during and at the end of the study period. The first will aim to ensure the study zones are comparable regarding the outcomes a) b) c) and d) and later on for comparison between zones. Furthermore, SP will be measured in urine using dipsticks for compliance measurement. An anthropological component will assess part of main outcomes e) and f) in health staff, communities, and pregnant women. Questionnaires, focus group discussions (FGD) and in-depth interviews (IDI) will be used for cross-sectional survey data collection. Data about pregnancy and IPT will be recorded from personal ANC book to be credible. The sample sizes will be calculated to be representative of the populations of different villages and zones.