Factors Influencing the Quality of Managing Severe Malaria among Children under Five Years at Selected County Hospitals in Kisumu, Kenya

Abstract

Context: Severe Malaria in children under the age of five is a major public health issue in Kisumu County, a malaria-endemic area in Kenya. Moreover, most severe Malaria cases in Kisumu West Subcounty are managed at Kombewa and Chulaimbo County hospitals. However, the influence of patient-related, caregiver-related, healthcare provider (HCP), and institutional-related factors on the management of severe Malaria in the area is not known.

Aim: The present study aimed to determine the factors influencing the quality of managing severe Malaria among children under five years at selected County hospitals in Kisumu, Kenya, namely Chulaimbo County Hospital and Kombewa County Hospital. 

Methods: A mixed-methods prospective cross-sectional study was conducted between April and July 2023. Qualitative data was collected from eight key informants (hospital administrators and ward in charge), while quantitative data was collected from 344 caregivers of children under five years of age who were managed for severe Malaria and 78 healthcare providers (nurses, clinical officers, and doctors) using survey questionnaires. An observational checklist was also used to collect quantitative data. Thematic analysis was used to analyze qualitative data, while descriptive statistics and logistic regression were used to analyze quantitative data. p<0.05 was considered significant.

Conclusion: These findings suggest that the optimal management of severe Malaria in children under the age of five in the study area is influenced by the gender of the patient, characteristics of the caregivers, on-job training of healthcare providers, and the availability of antimalarial medication. Moreover, these findings suggest that while healthcare providers are knowledgeable and committed to quality malaria management, systemic challenges such as resource limitations, caregiver education gaps, and treatment non-adherence impact their ability to deliver optimal care. Addressing these issues through resource allocation, continuous provider training, and community health education could strengthen severe malaria management in Kisumu County.