AWARENESS AND UTILIZATION OF AFFORDABLE MEDICINE FACILITY MALARIA AMONG CAREGIVERS OF UNDER FIVE CHILDREN IN IBADAN NORTHWEST LOCAL GOVERNMENT AREA, OYO STATE

Abstract

Access to Artemisinin Based Combination Therapy (ACTs) by most people at risk of malaria has been a challenge. A global subsidy under the initiative Affordable Medicine Facility-malarial (AMFm) was recommended to crowd out monotherapies, expand access to ACTs and therefore decrease the burden of malaria. AMFm-ACTs distribution started in Nigeria in 2011, but its use has not been documented. Hence, this study aimed at determining awareness, pattern of use, utilization and factors influencing utilization of AMFm-ACTs in Ibadan Northwest Local Government Area. The study was a cross sectional survey involving the use of cluster sampling technique to select 478 caregivers whose children had fever within two weeks prior to the survey. An interviewer administered questionnaire was used to collect information on awareness, knowledge of symptoms of malaria, sources of drugs, utilization and factors influencing utilization of AMFm- ACTs. Data was analyzed using descriptive statistics, Chi-square and multivariate logistic regression at 5% level of significance. The mean age of the respondents was 31.0 ± 5.4 years. Many of the caregivers (60.3%) were between 25 and 34 years, (89.3%) were married, and majority (60.6%) was Christians. More than half (61.7%) of the respondents had secondary education while 55.9% were traders. Less than half of the respondents (32.2%) were of high socio-economic status. Awareness of the programme was low as only 9.1 % have heard about the programme and less than half (42.9%) have seen the antimalarial packet that has the symbol of the Affordable Medicine Facility malaria. The commonest source of information on AMFm-ACTs was through the radio (31.7%). Overall, 29.2% used AMFm-ACTs as their first line choice of anti-malarial. More than half (54.5%) cited effectiveness of the drug as the main reason for choosing it. More than half of the respondents (51.2%) bought the drug by themselves while 35% received prescription from health workers. More than half of the respondent (82.1 %) reported availability of the anti-malarial whenever they buy it. Overall (61.5%) took the correct number of tablets in relation to their age and also for the recommended days. Most of the respondents discontinued the drug before the recommended time because symptoms got better. On bivarate analysis age group, occupation, level of education, socio-economic status, knowledge of symptoms of malaria, awareness of AMFm-ACTs, availability of AMFm-ACTs and sources of drug were significantly associated with utilization of AMFm-ACTs (P<0.05). Logistic regression demonstrated that only awareness (AOR: 13; CI: 5.731-30.509) predicted the use of AMFm-ACTs. For effective utilization of AMFm-ACTs, this study provides evidence that emphasis should be placed on awareness of this drug among those at risk of malaria and also increasing sensitization on treatment failure associated with cheap antimalarials. It equally proposes that programmes should be in place to educate people on appropriate dosing for AMFm-ACTs.