scholarly journals Factors Influencing Health Workers’ Compliance with the WHO Intermittent Preventive Treatment for Malaria in Pregnancy Recommendations in the Northern Region, Ghana

Author(s):  
Abdul Gafaru Mohammed ◽  
Dwomoh Duah ◽  
Ernest Kenu ◽  
Justice Nonvignon ◽  
Alex Manu ◽  
...  

Abstract Background Although IPTp-SP is a lifesaving WHO recommended preventive intervention for pregnant women in malaria-endemic regions, IPTp-SP uptake in the Northern region of Ghana is much lower than the sub-optimal national coverage level. Assessing the extent of health workers’ compliance and its associated factors will generate valuable pointers to be targeted at the program level. The study examined the factors influencing health workers’ compliance with the WHO recommended guidelines for IPTp-SP in the Northern Region. Methods A cross-sectional study among 315 health workers in the Northern region was conducted. Semi-structured questionnaires were used to collect data on health workers’ sociodemographic characteristics, facility-based factors and knowledge level. Data were collected on health workers’ compliance with the recommended practices through covert observations using a checklist. Facility observations were carried out using a checklist. Crude and adjusted logistic regression were used to determine predictors of health workers’ compliance, at 5% significance level adjusting for clustering. Results Of the 315 health workers studied, the median age was 29 years (26 – 34 years). Females constituted 252 (80.5%) of the 313 workers. The majority 148 (47.44%) of the 312 health workers were midwives. Overall, 56.2% (CI 51.0 – 62.0) were adequately complying with the recommended guidelines. Lower levels of compliance were recorded in health centers 15.6% (5.0 - 33.0) and CHPS compounds 21.2% (11.0 - 35.0). The factors associated with compliance included health workers’ knowledge (aOR = 7.64, 95% CI 4.21 - 13.87, p<0.001), job satisfaction (aOR 10.87, 95%CI 7.04 - 16.79, p<0.001), in-service training (aOR 10.11, 95%CI 4.53 - 22.56, p<0.001), supervision (aOR 4.01, 95%CI 2.09 - 7.68, p<0.001), availability of job aids (aOR 3.61, 95%CI 2.44 - 5.35, p<0.001), health workers experience (aOR = 10.64, 95% CI 5.99 - 18.91, p<0.001) and facility type (aOR 0.03, 95%CI 0.01 - 0.07, p<0.001). Conclusion Compliance with the recommended IPTp-SP guidelines is suboptimal in the region, with lower-level health facilities recording the least compliance levels. Health centers and CHPS facilities should be prioritized in distributing limited resources to improve health worker quality of care for antenatal care clients.

2019 ◽  
Author(s):  
Alren O. Vandy ◽  
Nana Yaw Peprah ◽  
Joseph Yaw Jerela ◽  
Perfect Titiati ◽  
Abubakar Manu ◽  
...  

Abstract Background About 25% of pregnant women in malaria endemic areas are infected with malaria and this accounts for about 15% of maternal death globally. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is one of the main strategies for prevention of malaria in pregnancy. A new recommendation was made by World Health Organization (WHO) that at least three doses of IPTp-SP should be administered before delivery. This study sought to determine the factors influencing adherence to the new IPTp-SP policy in Keta District, Volta region, Ghana. Methods A cross-sectional quantitative study among 375 nursing mothers at four selected health facilities in Keta district, Ghana was conducted using a structured questionnaire to interview participants. Data was analyzed using STATA 15. Chi-square was used to test bivariate association between categorical variables and adherence. Logistic regression analysis was used to examine sociodemographic, individual and institutional factors influencing adherence to IPTp-SP. Result About 82.1% of participants adhered to the WHO policy recommendations of at least three doses of IPTp-SP. However, only 17.1% received Ghana’s five dose coverage recommendation. The proportion of IPTp-SP coverage for IPTp1 was 98.9%; IPTp2 95.5%; IPTp3 80.8%; IPTp4 39.5%; IPTp5 17.1%. Conclusion Adherence to IPTp-SP was satisfactory according to WHO’s policy recommendation, however, majority of the participants had less than the five doses recommended in Ghana. Number of ANC visits and knowledge of malaria were the main determinants of adherence to IPTp-SP.


2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Oluwasomidoyin Olukemi Bello ◽  
Olaolu Oni

BACKGROUND: Malaria in pregnancy is of public health significance because of its associated maternal and fetal complications. This study aimed to assess health workers’ awareness and knowledge of the current World Health Organisation (WHO) recommendation of intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine (IPTp-SP).METHODS: A cross-sectional study among 148 health workers who offer obstetrics care in selected health facilities in Ibadan, Nigeria using a self-administered questionnaire to evaluate their awareness and knowledge of the current WHO IPTp-SP. Information on their socio-demographic and professional characteristics, awareness, knowledge and practice of the current IPTp recommendation were obtained. Data analysis involved descriptive and bivariate analyses using SPSS version 20.0 with level of significance set at p<0.05.RESULTS: The majority, 85(57.4%), of the health workers had been providing obstetrics care for less than 5 years with most of them, 114(77.0%), practicing at tertiary health facility. More than half, 92(62.2%), of them were aware of the current WHO IPTp-SP recommendation while about two-fifth (39.1%) had its correct knowledge. Of the health workers who were knowledgeable of the current IPTp-SP recommendation almost three-quarter, 29(72.2%) of them prescribed it. The health workers’ professional cadre (p<0.001) and duration of providing obstetrics care (p=0.012) were significantly associated with their awareness and correct knowledge of the current IPTp-SP recommendation.CONCLUSION: Most of the health workers are aware but not knowledgeable of the correct administration of the current IPTp- SP recommendation. Likewise, many of them do not prescribe it. This calls for regular training and update of health workers and institutional protocol so as to effectively reduce the prevalence of malaria in pregnancy and its complications.


2019 ◽  
Author(s):  
Alren O. Vandy ◽  
Nana Yaw Peprah ◽  
Joseph Yaw Jerela ◽  
Perfect Titiati ◽  
Abubakar Manu ◽  
...  

Abstract Background About 25% of pregnant women in malaria endemic areas are infected with malaria and this accounts for about 15% of maternal death globally. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is one of the main strategies for prevention of malaria in pregnancy. A new recommendation was made by World Health Organization (WHO) that at least three doses of IPTp-SP should be administered before delivery. This study sought to determine the factors influencing adherence to the new IPTp-SP policy in Keta District, Volta region, Ghana. Methods A cross-sectional quantitative study among 375 nursing mothers at four selected health facilities in Keta district, Ghana was conducted using a structured questionnaire to interview participants. Data was analyzed using STATA 15. Chi-square was used to test bivariate association between categorical variables and adherence. Logistic regression analysis was used to examine sociodemographic, individual and institutional factors influencing adherence to IPTp-SP. Result About 82.1% of participants adhered to the WHO policy recommendations of at least three doses of IPTp-SP. However, only 17.1% received Ghana’s five dose coverage recommendation. The proportion of IPTp-SP coverage for IPTp1 was 98.9%; IPTp2 95.5%; IPTp3 80.8%; IPTp4 39.5%; IPTp5 17.1%. Conclusion Adherence to IPTp-SP was satisfactory according to WHO’s policy recommendation, however, majority of the participants had less than the five doses recommended in Ghana. Number of ANC visits and knowledge of malaria were the main determinants of adherence to IPTp-SP.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Alren O. Vandy ◽  
Nana Yaw Peprah ◽  
Joseph Yaw Jerela ◽  
Perfect Titiati ◽  
Abubakar Manu ◽  
...  

Abstract Background About 25% of pregnant women in malaria-endemic areas are infected with malaria and this accounts for about 15% of maternal deaths globally. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is one of the main strategies for prevention of malaria in pregnancy. A new recommendation was made by the World Health Organization (WHO) that at least three doses of IPTp-SP should be administered before delivery. This study sought to determine the factors influencing adherence to the new IPTp-SP policy in Keta District, Volta region, Ghana. Methods A cross-sectional quantitative study among 375 nursing mothers at four selected health facilities in Keta district, Ghana was conducted using a structured questionnaire to interview participants. Sampling proportionate to the size of facility was used to determine the number of nursing mothers from each facility based on the caseload. For each facility systematic random sampling was used to select eligible nursing mothers. Data was analyzed using STATA 15. Chi-square was used to test bivariate association between categorical variables and adherence. Logistic regression analysis was used to examine sociodemographic, individual and institutional factors influencing adherence to IPTp-SP. Result About 82.1% of participants adhered to the WHO policy recommendations of at least three doses of IPTp-SP. However, only 17.1% received Ghana’s five dose coverage recommendation. The proportion of IPTp-SP coverage for IPTp1 was 98.9%; IPTp2 95.5%; IPTp3 80.8%; IPTp4 39.5%; IPTp5 17.1%. Conclusion Adherence to IPTp-SP was satisfactory according to WHO’s policy recommendation, however, majority of the participants had less than the five doses recommended in Ghana. Number of Antenatal Care (ANC) visits and knowledge of malaria were the main determinants of adherence to IPTp-SP.


2019 ◽  
Author(s):  
Alren O. Vandy ◽  
Nana Yaw Peprah ◽  
Joseph Yaw Jerela ◽  
Perfect Titiati ◽  
Abubakar Manu ◽  
...  

Abstract Background About 25% of pregnant women in malaria endemic areas are infected with malaria and this accounts for about 15% of maternal death globally. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is one of the main strategies for prevention of malaria in pregnancy. A new recommendation was made by World Health Organization (WHO) that at least three doses of IPTp-SP should be administered before delivery. This study sought to determine the factors influencing adherence to the new IPTp-SP policy in Keta District, Volta region, Ghana. Methods A cross-sectional quantitative study among 375 nursing mothers at four selected health facilities in Keta district, Ghana was conducted using a structured questionnaire to interview participants. Data was analyzed using STATA 15. Chi-square was used to test bivariate association between categorical variables and adherence. Logistic regression analysis was used to examine sociodemographic, individual and institutional factors influencing adherence to IPTp-SP. Result About 82.1% of participants adhered to the WHO policy recommendations of at least three doses of IPTp-SP. However, only 17.1% received Ghana’s five dose coverage recommendation. The proportion of IPTp-SP coverage for IPTp1 was 98.9%; IPTp2 95.5%; IPTp3 80.8%; IPTp4 39.5%; IPTp5 17.1%. Conclusion Adherence to IPTp-SP was satisfactory according to WHO’s policy recommendation, however, majority of the participants had less than the five doses recommended in Ghana. Number of ANC visits and knowledge of malaria were the main determinants of adherence to IPTp-SP.


Author(s):  
Wulan Citra Sari, Ana Safitri Wulan Citra Sari, Ana Safitri

ABSTRAK   Pneumonia masih merupakan masalah kesehatan yang penting karena menyebabkan kematian bayi dan balita yang cukup tinggi yaitu kira-kira satu dari empat kematian yang terjadi. Tujuan penelitian ini adalah diketahuinya hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Penelitian ini menggunakan metode Survey Analitik dengan pendekatan Cross Sectional. Populasi pada penelitian ini adalah semua ibu yang membawa atau memeriksakan balitanya yang umur < 5 tahun di Puskesmas Cambai tahun 2016, pada saat penelitian. Pengambilan sampel tersebut secara Non Random dengan teknik Accidental Sampling. Analisa data dilakukan secara univariat dan bivariat dengan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian menunjukkan ada hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Dari hasil penelitian ini, peneliti berharap petugas pelayanan kesehatan dapat meningkatkan pelayanan kesehatan bayi dan balita di Puskesmas Cambai , serta lebih sering melaksanakan penyuluhan tentang pneumonia dan penyuluhan mengenai makanan 4 sehat 5 sempurna, agar terciptanya balita sehat.     ABSTRACT Pneumonia is an important health problem because it causes the death of infants and toddlers are quite high, roughly one in four deaths. The purpose of this study is known huubungan between toddler age and maternal knowledge with pneumonia incidence in infants in health centers Cambai 2016. This study used a survey method with the Analytical cross-sectional approach. The population in this study were all mothers who carry their babies or check the age < 5 years at Health Center Cambai in 2016, at the time of the study. The sampling is non- random with accidental sampling technique. Data analysis was done using univariate and bivariate statistical test Chi - Square with significance level α = 0.05. The results of this study showed association between maternal age and knowledge toddlers with pneumonia incidence in infants in Health Center Cambai in 2016. From these results, researchers expect health care workers to improve health services in health centers babies and toddlers Cambai, and more frequently to conduct information about pneumonia and counseling about 4 healthy 5 perfect food , in order to create a healthy toddler.


Author(s):  
Clara Pons-Duran ◽  
Mireia Llach ◽  
Charfudin Sacoor ◽  
Sergi Sanz ◽  
Eusebio Macete ◽  
...  

Abstract Background Intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) is a key malaria prevention strategy in areas with moderate to high transmission. As part of the TIPTOP (Transforming IPT for Optimal Pregnancy) project, baseline information about IPTp coverage was collected in eight districts from four sub-Saharan countries: Democratic Republic of Congo (DRC), Madagascar, Mozambique and Nigeria. Methods Cross-sectional household surveys were conducted using a multistage cluster sampling design to estimate the coverage of IPTp and antenatal care attendance. Eligible participants were women of reproductive age who had ended a pregnancy in the 12 months preceding the interview and who had resided in the selected household during at least the past 4 months of pregnancy. Coverage was calculated using percentages and 95% confidence intervals. Results A total of 3911 women were interviewed from March to October 2018. Coverage of at least three doses of IPTp (IPTp3+) was 22% and 24% in DRC project districts; 23% and 12% in Madagascar districts; 11% and 16% in Nigeria local government areas; and 63% and 34% in Mozambique districts. In DRC, Madagascar and Nigeria, more than two-thirds of women attending at least four antenatal care visits during pregnancy received less than three doses of IPTp. Conclusions The IPTp3+ uptake in the survey districts was far from the universal coverage. However, one of the study districts in Mozambique showed a much higher coverage of IPTp3+ than the other areas, which was also higher than the 2018 average national coverage of 41%. The reasons for the high IPTp3+ coverage in this Mozambican district are unclear and require further study.


2016 ◽  
Vol 1 (2) ◽  
pp. 61-70
Author(s):  
R.Oktaviance Simorangkir ◽  
Lilis Sumardiani

In the Working Area of Pancur Batu Puskesmas class, pregnant women begin to be implemented in 2016, but still found the low knowledge of pregnant women about the ideal pregnancy examination and there are pregnant women who show unimportant attitude checking pregnancy to health workers. Goals : The purpose of this research is to know the influence of maternal class on pregnant mother's knowledge and attitude about pregnancy examination and treatment. Methods : The study used a quantitative method with cross sectional design. The population of 151 pregnant women in Pancur Batu Community Health Center and 132 of them (63 pregnant women who had attended pregnant mother class and 69 pregnant women who never attended maternal class) were used as samples. Data analysis using independent t test at significance level α = 0,05. Result : The results showed the total range of knowledge scores of mothers who had followed the class of pregnant women is 7-13 with an average value of 10.08 ± 1.82, while the total range of scores of mothers who never follow the pregnant women's class is 1-9 with an average value 4,97,1,94. There is a maternal class effect on maternal knowledge of examination and treatment of pregnancy (p <3,82. There is a maternal class effect on maternal attitudes about examination and treatment of pregnancy (p3.13, while the total range of maternal scores that never follow the class of pregnant women is 27-47 with an average value of 35 , 410.001). The total score of attitudes of mothers who have attended the class of pregnant women is 41-56 with an average score of 48.24 <0.001). Conclution : It is expected that the Health Office to schedule Pancur Batu Puskesmas to carry out pregnant women's classes regularly and carried out 2 periods a year. Pancur Batu Puskesmas is expected to maintain the quality of pregnant women's classes and counseling invites all pregnant women to follow the class of pregnant women.


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