Assessment of Compliance with National Guidelines on Diagnosis and Treatment of Malaria among Health Workers in Anambra State, Nigeria

Abstract

Background: Malaria case management remains a crucial component of malaria control strategies. Despite the introduction of national malaria treatment guidelines and scale-up of malaria control interventions in Nigeria, shreds of evidence have shown some deviations from the guidelines in malaria case management. This study assessed compliance with national guidelines on the diagnosis and treatment of malaria among health workers in Anambra State. Materials and Methods: This comparative, cross-sectional hospital-based study was carried out among 360 healthcare workers selected from six Local Government Areas using a multistage sampling technique. A pre-tested interviewer-administered questionnaire was used to collect data on their socio-demographics and other vital information. Results: The findings of this study revealed that Ninety-eight respondents (54.4%) from public health facilities had adequate knowledge of malaria case management compared to 67 respondents (37.2%) from private health facilities (p=0.001). The overall level of compliance with the national guidelines shows that only 22.2% of the health workers interviewed strictly complied with the national guidelines. It was significantly higher among public healthcare workers (31.7%) compared to 12.8% of private health workers (p<0.001). Training on malaria case management, access to national guidelines, availability of malaria diagnostic tools, and sex of the health workers were associated with compliance with national guidelines in both public and private health facilities (p<0.001). Conclusion: The findings of this study revealed a close similarity between the two health facilities in the level of awareness of the national malaria treatment guidelines, but a remarkable difference in compliance to appropriate case management of malaria between public and private health facilities. Interventions to improve private sector engagement in the implementation of the guidelines, training, and supply of recommended anti-malarial medicines should be intensified.