Factors associated with non-adherence to standard diagnosis and treatment guideline in the management of malaria in pregnancy

Abstract

Background: Non adherence to National Malaria Diagnosis and Treatment Guideline (NMTG) in the treatment of malaria in pregnancy contribute to the increase of poor maternal health and birth outcome effects related to malaria infections.

Objective: To determine the contributing factors for non-adherence to NMTG among the health care workers (HCWs) in public  dispensaries and health centres in Kilimanjaro region.

Method: A cross sectional study in which the health care workers attending pregnant women were interviewed; 179 participants from 60 dispensaries and 16 health centres were interviewed between February and April 2018. Data management and analysis were performed using Statistical Package for Social Sciences (SPSS) version 20 for Window (SPSS Inc., Chicago, IL, USA).

Results: In this study 37.4% of the participants were not adhering to NMTG during the management of malaria cases in pregnancy.  After controlling for potential confounders, factors which were associated with non-adherence to NMTG were; client overload  (AOR=3.025; 95%CI 1.136-7.162; p-value=0.009) and inadequate supply of Rapid diagnostic tests (RDTs) (AOR=3.15; 95% CI 1.14-9.559; p=0.000).

Conclusion: Factors which are associated with non adherence to standard malaria diagnosis and treatment guideline are inadequate supply of diagnostic tests and clients overload in the public health facilities.

Key words: Malaria, Guideline, Non-adherence, pregnancy