Clinicians’ Adherence with Malaria Treatment During Pregnancy in the Tamale Metropolis of Ghana

Abstract

Aims: Clinicians' compliance with malaria treatment protocols in pregnancy is paramount to safeguarding the good health of the mother and the unborn baby. However, ensuring clinicians' compliance with these guidelines has been challenged by drug factors, patients’ factors, and clinicians’ experiences. This study aimed to assess clinicians' compliance with malaria treatment guidelines during pregnancy and exploring factors influencing compliance and challenges they encounter. Study Design: The study employed a convergent mixed-method (quantitative and qualitative) design. Place and Duration of Study: The study was done in three hospitals including the Tamale Reproductive and Child Health (RCH), Universal Health Clinic (UHC) and the Tamale Teaching Hospital (TTH). These hospitals are representative of primary, secondary, and tertiary hospitals respectively in the metropolis. For the quantitative study, consultation details of 203 pregnant women managed for malaria from May to October 2022 were reviewed. Methodology: Descriptive statistics were used to summarize the data. Binary logistic regression was used to examine the association between variables. The study conducted a face-to-face interview with 21 health professionals in the selected health facilities. Thematic analysis was used to analyze qualitative data. Results: The study revealed that clinicians’ compliance with the protocol was very low (2.8%) in the first trimester. Compliance was 100% in the third trimester. Malaria laboratory tests, signs and symptoms, and gestation age of the pregnancy were found to be associated with treatment compliance. Other factors include clinicians’ experiences such as fear of medication side effects, patient health beliefs and adherence, professional norms, and the location or level of the health facility influenced compliance. Conclusion: The study revealed low compliance with malaria treatment protocol in the first trimester of pregnancy mainly due to adverse effects of quinine and colleagues professionals’ influences. There is the need to monitor clinicians’ compliance with the guidelines for malaria treatment in pregnancy and ensure clinicians comply or address challenges in the guideline to protect pregnant women with malaria.