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American Journal of Public Health Research. 2014, 2(4), 125-135
DOI: 10.12691/AJPHR-2-4-2
Original Research

Providers’ Knowledge of the Guidelines for Intermittent Preventive Treatment for Malaria in Pregnancy: Evidence from Bungoma East District, Kenya

Angela Chepkemoi Ng’etich-Mutulei1, and Tom Odhiambo1

1Health and Social Services, Kenya Red Cross Society, Nairobi, Kenya

Pub. Date: June 18, 2014

Cite this paper

Angela Chepkemoi Ng’etich-Mutulei and Tom Odhiambo. Providers’ Knowledge of the Guidelines for Intermittent Preventive Treatment for Malaria in Pregnancy: Evidence from Bungoma East District, Kenya. American Journal of Public Health Research. 2014; 2(4):125-135. doi: 10.12691/AJPHR-2-4-2

Abstract

Introduction: Intermittent Preventive Treatment for malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine is a key intervention for malaria prevention. Providers’ knowledge of IPTp guidelines is crucial for effective services and achievement of the Roll Back Malaria target. This study assessed providers’ knowledge of the IPTp guidelines, with a view to contributing towards policy deliberations aimed at improving providers’ knowledge and service quality. Methods: We sourced primary data from 34 providers working in public health facilities, including the district and sub-district hospitals, health centres, and dispensaries. The test items included definition of IPTp; timing of the first IPTp dose; whether women on cotrimoxazole should be given IPTp; as well as whether IPTp can be given with folic acid, among others. Quantitative analysis techniques included frequency distributions and cross-tabulations with Chi Square statistic. Findings: Only one-third (29.4%) of the participants provided correct responses to all the ten test items; hence, were considered to be ‘knowledgeable’ about the guidelines. About 56% of the providers had accessed some training on IPTp, while a significant variation in IPTp knowledge emerged between trained and untrained providers. The study also found significant variation in providers’ knowledge of most guidelines across the cadres as well as across health facility tiers. Interpretation: The failure of about 71% of the providers to state correct responses to all the test items suggests that providers’ knowledge of the guidelines remains low. Trained providers were likely to be more knowledgeable than their untrained counterparts were; clinical officers were likely to be more knowledgeable than community health workers were, while providers at the district hospital were likely to be more knowledgeable than providers at the dispensaries were. The study recommends the need to scale-up in-service training; package and disseminate the guidelines in portable materials; and prioritize training opportunities for lower cadres and providers in lower tier facilities.

Keywords

Intermittent Preventive Treatment, Providers' knowledge, Pregnancy, Malaria Prevention, Malaria Control

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  Akinleye, S.O., Falade, C.O. and Ajayi, I.O. “Knowledge and utilization of intermittent preventive treatment for malaria among pregnant women attending antenatal clinics in primary health care centers in rural southwest, Nigeria: a cross-sectional study.” BMC Pregnancy and Childbirth 2009; 9(28): 1-9.
 
[2]  Ali, N.S. “Prediction of Coronary Heart Disease Preventive Behaviours in Women: A Test of the Health Belief Model”. Women and Health 2002; 35(1): 83-96.
 
[3]  Arulogun, O.S., and Okereke, C.C. “Knowledge and Practices of Intermittent Preventive Treatment of Malaria in Pregnancy among Health Workers in a Southwest Local Government Area of Nigeria.” Journal of Medicine and Medical Sciences 2012; 3(6): 415-422.
 
[4]  Bryman, A., and Cramer, D. (1997). Quantitative Data Analysis with SPSS for Windows: a guide for Social Scientists. London: Routledge.
 
[5]  Bryman, A., and Cramer, D. (1997). Quantitative Data Analysis with SPSS for Windows: a guide for Social Scientists. London: Routledge.
 
[6]  Diala, C.C., Pennas, T., Marin, C. and Belay, K.A. “Perceptions of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) and Barriers to Adherence in Nasarawa and Cross River States in Nigeria.” Malaria Journal 2013; 12(342).
 
[7]  Donkor, E.S. and Asiedua, E. “Knowledge, Practices and Challenges of Intermittent Malaria Preventive (IPT) Treatment during Pregnancy in Ghana.” African Journal of Nursing and Midwifery 2011; 13(1): 34-45.
 
[8]  Hill, J. and Kazembe, P. “Reaching the Abuja Target for Intermittent Preventive Treatment of Malaria in Pregnancy in African Women: A Review of Progress and Operational Challenges.” Tropical Medicine and International Health 2006; 11(4): 409-18.
 
[9]  Kenya National Bureau of Statistics and ICF Macro (2010). Kenya Demographic and Health Survey 2008-09. Calverton, Maryland: KNBS and ICF Macro.
 
[10]  KNBS (2010). The National Population and Housing Census 2009 Report, Nairobi, Kenya.
 
[11]  Luxemburger, C., Ricci, F., Nosten, F., Raimond, D., Bathet, S. and White, N. J. “The Epidemiology of Severe Malaria in an Area of Low Transmission in Thailand.” Transactions of the Royal Society of Tropical Medicine and Hygiene 1997; 91: 256-262.
 
[12]  Mboera, E.G.L., Makundi, E.A. and Kitua, A.Y. “Uncertainty in Malaria Control in Tanzania: Crossroads and Challenges for Future Interventions”. American Journal of Tropical Medicine 2007; 77(6): 112-18.
 
[13]  Ministry of Health (Kenya) (2006). National Guidelines for Diagnosis, Treatment, and Prevention of Malaria for Health Workers in Kenya. Nairobi: Division of Malaria Control, Ministry of Health.
 
[14]  Ministry of Planning & National Development (2010). Bungoma East District Annual Operational Plan 2010-2011. Nairobi.
 
[15]  Ministry of Public Health and Sanitation, Kenya National Bureau of Statistics and ICF Macro (2011). 2010 Kenya Malaria Indicator Survey. Nairobi: DOMC, KNBS, and ICF Macro.
 
[16]  Mubyazi, G., Bloch, P., Kamugisha, M., Kitua, A., Ijumba, J. “Intermittent Preventive Treatment for Malaria during Pregnancy: A Qualitative Study of Knowledge, Attitudes, and Practices of District Health Managers, Antenatal Care Staff, and Pregnant Women in Korogwe District, North-Eastern Tanzania.” Malaria Journal 2005; 20 (4): 31.
 
[17]  Nachmias, C.F., and Nachmias, D. (1996). Research Methods in the Social Sciences, 5thEdition. London: Arnold.
 
[18]  Ngindu, A., Kigondu, S., Ayuyo, C., Kidula, N., Malonza, I., Washika, E., Mwangangi, A., Kimitei, J., Njiru, P., and Juma, E. (2009). Improving provision of quality IPTp services: Use of Rapid Results Initiative in facility-based dissemination of simplified Malaria in Pregnancy guidelines in Kenya. Nairobi: JHPIEGO.
 
[19]  Onyeaso, N.C., and Fawole, A.O. “Perception and Practice of Malaria Prophylaxis in Pregnancy among Healthcare Providers in Ibadan.” African Journal of Reproductive Health 2007; 11(2): 69-78.
 
[20]  Ouma, P.B., van Eijk, A.M., Hamel, M.J., Sikuku, E., Odhiambo, F., Munguti, K., Ayisi, J.G., Krager, P.A., and Slutsker, L. “The Effect of Health Care Worker Training on the Use of Intermittent Preventive Treatment for Malaria in Pregnancy in Rural Western Kenya.” Tropical Medicine and International Health 2007; 14(8):953-961.
 
[21]  Parise, M.E., Ayisi, J.G., Nahlen, B.L., Schultz, L.J., Roberts, J.M., Misore, A., Muga, R., Oloo, A.J., and Steketee, R.W. “Efficacy of Sulfadoxine Pyrimethamine Prevention of Placental Malaria in an Area of Kenya With a High Prevalence of Malaria and Human Immunodeficiency Virus Infection.” American Journal of Tropical Medicine and Hygiene 1998; 59(5): 813-822.
 
[22]  Rindfleisch, A., Malter, A.J., Ganesan, S. and Moorman, C. “Cross-Sectional Versus Longitudinal Survey Research.” Journal of Marketing Research 2008; 45(3): 1-23.
 
[23]  Rindfleisch, A., Malter, A.J., Ganesan, S. and Moorman, C. “Cross-Sectional Versus Longitudinal Survey Research.” Journal of Marketing Research 2008; 45(3): 1-23.
 
[24]  Schultz, L.J., Steketee, R.W., Macheso, A., Kazembe, P., Chitsulo, L., and Wirima, J.J. “The Efficacy of Antimalarial Regimens Containing Sulfadoxine-Pyrimethamine and/or Chloroquine in Preventing Peripheral and Placental Plasmodium Falciparum Infection Among pregnant Women in Malawi.” American Journal of Tropical Medicine and Hygiene 1994; 51(5): 515-522.
 
[25]  Shulman, C.E., Dorman, E.K., Cutts, F., Kawuondo, K., Bulmer, J.N., Peshu, N., and Marsh, K. Intermittent Sulphadoxine-Pyrimethamine to Prevent Severe Anaemia Secondary to Malaria In Pregnancy: a Randomized Placebo-Controlled Trial.” Lancet 1999; 353:632-636.
 
[26]  Steketee, R.W., Wirima, J.J., Campbell, C.C. “Developing effective Strategies for Malaria Prevention Programs for Pregnant African Women.” Am J of Trop Med and Hyg1996; 55:95-100.
 
[27]  Tarimo, S.D. (2007). “Appraisal on the Prevalence of Malaria and Anaemia in Pregnancy and Factors Influencing Uptake of Intermittent Preventive Therapy with Sulfadoxine-Pyrimethamine in Kibaha District, Tanzania”. East African Journal of Public Health 2007; 4:80-3.
 
[28]  Thiam, S., Kimotho, V. and Gatonga, P. “Why are IPTp Coverage Targets so Elusive in Sub-Saharan Africa? A Systematic Review of Health System Barriers.” Malaria Journal 2013; 12 (353).
 
[29]  Verhoeff, F.H., Brabin, B.J., Chimsuku, L., Kazembe, P., Russel, W.B., and Broadhead, R.L. “An Evaluation of Intermittent Sulfadoxine-pyrimethamine Treatment in Pregnancy on Parasite Clearance and Risk of Low Birth Weight in Rural Malawi.” Annals of Tropical Medicine and Parasitology 1998; 92:141-150.
 
[30]  World Health Organization (2005). A strategic framework for malaria prevention and control during pregnancy in the African Region. Brazzaville: WHO.
 
[31]  World Health Organization (2007). Malaria in Pregnancy: Guidelines for Measuring Key Monitoring and Evaluation Indicators. Geneva: Global Malaria Program.
 
[32]  World Health Organization (2012). Updated WHO Policy Recommendation (October 2012) on Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine- Pyrimethamine (IPTp-SP). Geneva: Global Malaria Program.
 
[33]  World Health Organization (2013). World Malaria Report 2013. Geneva: Global Malaria Program.
 
[34]  Wuensch, K.L. (2006). Logistic Regression with SPSS. http://core.ecu.edu/psyc/wuenschk/spss/logistic.sav. Accessed on 22/4/2013.