ASSESSMENT OF IMPLEMENTATION OF NATIONAL MALARIA CONTROL PROGRAMME BY HEALTH CARE WORKERS IN PRIMARY HEALTH CENTRES IN OGUN STATE, SOUTH WEST NIGERIA

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ASSESSMENT OF IMPLEMENTATION OF NATIONAL MALARIA CONTROL PROGRAMME BY HEALTH CARE WORKERS IN PRIMARY HEALTH CENTRES IN OGUN STATE, SOUTH WEST NIGERIA

Abstract

Background: Nigeria accounts for one quarter of all the malaria cases in Africa; there are more deaths due to malaria in Nigeria than in any other country in Africa. Nigeria has one of the world’s highest rates of all-cause mortality for children under five: approximately one in six children die before their fifth birthday. There are several challenges to providing prompt and effective treatment for malaria in Africa. First, the majority of malaria cases are not seen within the formal health sector. Second, the resistance of P. falciparum parasites to conventional anti-malarial monotherapies, such as chloroquine, sulfadoxine- pyrimethamine and amodiaquine, has become widespread, resulting in new treatment recommendations. The objective of this study is to assess the implementation of national malaria control program by health care workers in Primary Health Centres in Ogun State, south west, Nigeria.
Method: The study was a descriptive cross sectional study among 325 health care workers. These health care workers were from 75 Primary Health Centres in three Local Government Areas of Ogun State, these LGAs include; Ado-odo/ Ota, Ewekoro and Ijebu-ode LGAs. The study was conducted between September to December 2013. A cluster sampling technique was employed. Data was collected using a pre-tested, semi-structured self-administered questionnaire and an observational checklist. Ethical clearance was obtained from OlabisiOnabanjo University Teaching Hospital Health Research Ethic committee and Ogun State Primary Health Care Board.
Results: One hundred and twenty-five (38.5%) of the respondents were from Ado-odo /Ota LGA, 120 (36.9%) of the respondents were from Ijebu-ode LGA and 80 (24.6%) were from Ewekoro LGA. Three hundred and fifteen of the respondent (96.9%) knew the causative
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organism of malaria. Only 40.9% of the respondents could identify presentation of complicated malaria. A high proportion (89.2%) of the respondents agreed that National Malaria Control Programme interventions have both prevention and case management component. The knowledge of Intermittent Preventive Therapy among the respondents was good (>90%) but implementation of IPT was inadequate. Less than 20% of the respondents use light microscope to confirm diagnosis of malaria while 45.5% of the respondents use clinical suspicion to make diagnosis of malaria. The older health workers were statistically significantly more knowledgeable than the younger health workers (χ2= 15.212, p-value =0.004). Health workers with >15 years of work at the PHC had good knowledge on the implementation of NMCP compared with health workers with <15 years of work at the PHC (p-value = 0.006). Thirty-four (45.3%) PHCs were visited in Ado-odo/Ota, 24 (32%) PHCs in Ewekoro and 17 (22.7%) PHCs in Ijebu-ode. About 70% of the PHCs had availability of Long Lasting Insecticide Nets. Only 32.0% of the PHCs had LLINs on the hospital beds. None of the PHCs had Indoor Residual Spray available. Thirty-six per cent of the PHCs had Information Education Communication (IEC) materials displayed on their walls. Only 46.7% of the PHCs had monitoring and evaluation forms. Half (50.7%) of the PHCs presented their malaria data up to date.
Conclusion: Knowledge of the health care workers on mode of transmission of malaria was good but their knowledge on the signs and symptoms of malaria was inadequate. Knowledge of the health care workers on the National Malaria Control Programmes was good however the implementation of National Malaria Control Programme was inadequate. It is therefore recommended that there should be regular and more frequent monitoring and supervisory visits to the health facilities especially in the remote areas.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

 

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

 

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

 

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

 

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

 

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

ASSESSMENT OF IMPLEMENTATION OF NATIONAL MALARIA CONTROL PROGRAMME BY HEALTH CARE WORKERS IN PRIMARY HEALTH CENTRES IN OGUN STATE, SOUTH WEST NIGERIA

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