Knowledge, Perception and Management of Malaria in Pregnancy by Traditional Birth Attendants in Benin City

Abstract

It is recommended that anti-malarial interventions should be delivered to pregnant women during antenatal clinic visits; however, this recommendation is poorly implemented in many malaria endemic countries. Community-based approaches, including the use of traditional birth attendants (TBAs) could complement formal health care services in the delivery of these intervention programmes. The objective of this study was to assess TBAs’ knowledge, perception and management of malaria during pregnancy in Benin City, Nigeria. The TBAs were sampled, using snowball census method (A sampling technique that relies on referrals from initial subjects to generate additional subjects) from Egor Local Government Area, Benin City, Nigeria. Data collection involved in-depth interviews, conducted on the TBAs, using a semi-structured, thematic questionnaire with series of open-ended and close-ended questions, which served as a topic guide during the interviewing process. Although a majority of the respondents correctly mentioned infected mosquitoes as the mode of malaria transmission; they also thought that malaria could be caused by other means. Some thought that malaria is caused by poisoned food/water, too much stress, infection of the “womb” (uterus), high body temperature, etc. They were not aware of the currently recommended anti-malarial interventions for pregnant women in the country, which include sleeping under insecticide treated bed nets (ITNs) and using sulphadoxine/pyrimethaminebased intermittent preventive therapy (IPTsp). However, they said that they were willing to be educated on their usage. The study also revealed that the TBAs had poor management practices of malaria in pregnancy, and different herbal preparations of unknown constituents were most commonly recommended for their clients. The TBAs had misconceptions regarding knowledge and management of malaria during pregnancy. The policy implication of these findings is that for TBA to play important role in the prevention and control of malaria in pregnancy in Benin City, Nigeria, they would require adequate training and supervision.

Key words: Malaria in pregnancy, management, traditional birth attendants.