OUTCOME OF TRAINING ON HEALTH WORKERS' KNOWLEDGE AND PERCEPTIONS OF CURRENT ANTI-MALARIA TREATMENT POLICY AND PRESCRIPTION PATTERN IN IBADAN METROPOLIS

Abstract

Malaria is a major public health issue in Nigeria. Despite the existence of a national malaria response and the National Antimalarial Treatment Policy (NATP), the prevalence is still high. Health workers have pivotal roles to play in the implementation of the policy but their knowledge of the policy has not been adequately assessed. Hence, information on health workers' knowledge and perception of the policy and pattern of antimalarial prescriptions would enhance health workers adherence to treatment policy. This study was designed to investigate the outcome of training on health workers' awareness, knowledge of current treatment policy perception and prescription pattern of anti-malarial medicines in Ibadan Metropolis. A quasi-experimental design was used for this study. Sixty participants (Nurse/Midwives, Community Health Extension Workers/Officers & Pharm.Tech\Assistants) were purposively selected from primary health care facilities in two Local Government Area (LGA) in lbadan Metropolis. Ibadan North West was the experimental group while lbadan South East was the control. The training content was on awareness and knowledge of current treatment policy; perception and prescription pattern of anti-malarial medications. Data were collected using a pretested, interviewer-administered questionnaire; with questions on socio-demographic characteristics, awareness, knowledge of the current NATP; perception and antimalarial prescribing patterns. Respondents' knowledge was measured using a 66-point scale consisting of identification, rationale and management of malaria using the NATP. Knowledge scores <3 and ≥33 were rated as poor and good, respectively. Data were analysed using descriptive and inferential statistics at p = 0.05. Most respondents (93.8%) were female and over 40.0% were above 40 years of age. About 46.0% were Community Health Extension Workers, while 6.0% were Nurses. Awareness of the current antimalarial treatment policy was 87.5% and 76.7% at pre-intervention compared to 100.0% and 98.3% at post intervention among the experimental and control. Almost all the respondents in the experimental and control had heard about Arthemisinin Combination Therapy (ACT) pre and post intervention. At post-intervention, 75.0% and 3.6% of respondent in the experimental and control groups indicated that Arthemeter Lumefantrine was the current medicine for malaria treatment compared to 5.0% and 0.0% at pre-intervention. Respondents' knowledge increased from 52.5% (47.2±7.5) at baseline to 100.0% (63.1±95.6) in the experimental group while there was a decrease in knowledge in the control group from 70.0% (50.8±12.6) to 60.7% (47.2±7.9). Arthemeter Lumefantrine was most preferred (78.1%) as the first line antimalarial medicine at post-intervention than at pre-intervention (17.5%) in the experimental group. Prescription pattern of antimalarial medicines among health workers across all ages was not in line with the policy recommendations. There was increase in knowledge of anti-malaria policy among health workers in lbadan metropolis. However the prescription pattern of Artemisinin-based Combination Therapy was not in line with the policy recommendation, therefore more training to enhance correct anti-malarial prescription pattern among health workers is recommended.