Picture a place where more than 80% of people carry Schistosoma mansoni. Now picture a pregnant woman there being sent home with nothing. Not because the drug is missing, but because nobody wrote down that she should get it. A qualitative study of nine healthcare providers in Tanzania’s Mwanza region found exactly that. The real bottleneck in maternal schistosomiasis is not access to praziquantel in pregnancy. It is the missing policy that tells clinicians to use it. This piece looks at what doctors, pharmacists, and nurses said, and what it means for how programs get built. Schistosomiasis is a parasitic disease. People catch it when they touch freshwater that carries…