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EFFECT OF TRAINING ON KNOWLEDGE, ATTITUDE AND PRACTICE OF TRADITIONAL BIRTH ATTENDANTS REGARDING PREVENTION OF MALARIA IN PREGNANCY IN BADAGRY LOCAL GOVERNMENT AREA IN LAGOS STATE
Abstract
Introduction: Each year, approximately 25 million women in Africa become pregnant in malaria-endemic areas in Africa and are at risk of malaria infection during pregnancy, an
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infection which contributes approximately 16-20% of maternal mortality and morbidities. More than 60% of these women visit the traditional birth attendants for their antenatal care, rather than the orthodox health facilities. This study was carried out to determine the effect of training on the knowledge, attitude and practices of TBAs regarding the prevention of malaria in pregnancy at a rural local government in Lagos State.
Materials and Methods: This study was a non-randomised, controlled intervention study. Purposive sampling method was used to select the intervention and control communities and all consenting registered traditional birth attendants were recruited for the study. Following the interviewer-administered questionnaire survey and focus group discussions for the two groups, training on prevention of malaria in pregnancy was conducted for the intervention group employing question and answer sessions, group discussions, role-plays, didactic lectures, trainer demonstrations, use of pictures and sharing experiences. Post intervention questionnaire administration was done after three months and data from both baseline and post intervention surveys were analysed using Epi-Info and WinPepi softwares and presented in frequency tables and cross tabulations.
Results: Pre-intervention, the study found very high malaria awareness (100%) among the TBAs, and a significant amount of them (98.5%) knew that malaria can cause problems/complications for the pregnant women and their children in pregnancy, if not prevented or well managed. Although the overall knowledge of the respondents on malaria in pregnancy and prevention strategies was very poor (97.2%) in the intervention group and (71.9% in the control), about half of the respondents that were aware of IPT had fair to good knowledge of it. Also, all (100%) of the respondents who were aware of IPT had good attitude towards use of IPT for prevention of malaria in pregnancy. But only 8.3% of the respondents in the study
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group (and 3.2% in the control) was prescribing IPT-sp for their clients, and none of them even referred them to health centres or other private/public health facilities for it. A good number of the respondents (69.4%) in the intervention group claimed that they kept records of all their activities, but none (0.0%) of them kept any record for IPT, and ITN.
The training intervention on prevention of malaria in pregnancy significantly increased the overall level of knowledge in the intervention group from largely poor (97.2%) to fair (86.7%) compared to the control group. Their attitude score also significantly improved by 25.0% compared with the control group with 0.6% change. The training, however, did not improve significantly their record keeping practices. Eighty percent (80.0%) compared with 69.4% of the respondents in the intervention group practiced record keeping post intervention. Also their IPT-sp prescription practices did not change significantly (8.4%) post intervention; though, compared with the control, a statistically significant increased number of respondents in the intervention group claimed that they counselled their clients on IPT-sp, 70.0% compared with 0.0% at the baseline; and ITN 86.7% compared with 12.5%, and referred their clients for IPT-sp 78.6% compared with 0% (p<0.05).
Conclusion: The training succeeded in improving the level of knowledge, attitude, and some practices of malaria in pregnancy prevention especially as regards counseling and referral for IPT, though some areas of deficiencies still persisted.
Recommendations: Lagos State Traditional Medicine Board with the collaboration of the Local Government Authorities and other stakeholders should be advised on the need to incorporate and engage the TBAs in the ongoing efforts to prevent malaria and its complications in pregnancy by training/retraining and monitoring them to deliver the IPT-sp at the community level.
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
EFFECT OF TRAINING ON KNOWLEDGE, ATTITUDE AND PRACTICE OF TRADITIONAL BIRTH ATTENDANTS REGARDING PREVENTION OF MALARIA IN PREGNANCY IN BADAGRY LOCAL GOVERNMENT AREA IN LAGOS STATE
