Pattern of management for malaria in pregnancy by public and private health providers in Lagos

Abstract

Background: Malaria in pregnancy is a major public health problem contributing significantly to high morbidity and mortality. Malaria infection during pregnancy predisposes to adverse pregnancy outcomes which include; miscarriage, premature delivery, small for date babies, maternal anaemia and even intrauterine death. Utilization of current national antimalarial treatment guideline showed low level of use of antimalaria guideline by healthcare providers.

Objective: The aim of this study was to determine and compare the knowledge, attitude and practice of healthcare providers about malaria in pregnancy in public and private secondary hospitals in Lagos State.

Method: This is a comparative, cross sectional study that assessed the factors influencing health care providers knowledge, attitude and practice in public and private secondary health facilities in Lagos State. Data was collected using a pretested questionnaire administered to 302 healthcare providers selected through multistage sampling. Date generated was analysed with Epi-Info 2012 version.

Results: The public providers were more (85.4% and 66.75) knowledgeable about the use of microscopic test and rapid diagnostic tool respectively compared to private providers (75.6% and 42.0%). Majority of the providers (87.7% and 84.9%) in both public and private facilities respectively had knowledge of IPTp. Majority of the public providers (93.6%) believed that malaria in pregnancy is very serious while a lesser proportion (82.4%) of the private providers believed the same. Majority of the public health providers (64.9%) used Artemisinin based combination therapy (ACT) in treatment of malaria in pregnancy in 2^nd trimester while a lower proportion (55.5%) of the private providers used ACT in treatment of malaria in pregnancy in 2^nd trimester.

Conclusion: In conclusion, the pattern of antimalarial prescription among secondary health care providers in Lagos State varied widely among the practitioners and the fact that less than half of both public and private health care providers strongly agreed to direct observation of therapy showed that their practice does not fully embraced the evidence based recommendations of the World Health Organization and the National Antimalarial treatment  guideline. However, the public providers had a better practice regarding the management of malaria in pregnancy.

Keywords: Case management, malaria, pregnancy