Perception and practice of malaria prophylaxis in pregnancy among primary health care providers in Ibadan, Nigeria.
BACKGROUND
Pregnant women and their unborn babies are especially vulnerable to malaria. Malaria infection during pregnancy is associated with increased risk of maternal anaemia, spontaneous abortion, stillbirth, low birth weight and neonatal death.


OBJECTIVE
To assess knowledge and practice of malaria prophylaxis during pregnancy among primary health care providers in Ibadan, south-western Nigeria.


METHODS
Participants were randomly selected from primary health centres and private health facilities in two local governments within Ibadan municipality. All cadres of health professionals in the selected health facilities were interviewed using a semi-structured self -administered questionnaire.


RESULTS
Two hundred and eighty-seven participants selected from 42 primary healthcare facilities comprising of 48 (16.7%) CHEWs, 133 (46.3%) auxiliary nurses, 84 (29.3%) trained nurses and 22 (7.7%) medical doctors completed the questionnaires. Healthcare providers in private health facilities formed the bulk (80.5%) of respondents. Respondents' knowledge of malaria prevention strategies was generally poor across all professional cadres. Only 40 (13.9%) respondents had correct knowledge of WHO strategies. Awareness of IPT was significantly higher among respondents from public health facilities compared with private health facilities--93.0% versus 80.9% (p < 0.05) One hundred and fifty-six (54.4%) respondents knew the correct drug, dosage and timing of IPT. Only forty-six (16.0%) respondents were aware that at least three doses of IPT were required for HIV patients. Pyrimethamine was significantly more commonly prescribed in private health facilities compared with public health facilities (p < 0.05) Chloroquine was still commonly prescribed by respondents in public and private health facilities. The use of insecticide treated nets was recommended by 77.4% of respondents.


CONCLUSIONS
Knowledge about current malaria prevention strategies during pregnancy is poor among health care providers at the primary level of care. Efforts aimed at improving malaria prevention in the primary health care setting must incorporate providers in private health facilities who are responsible for a larger proportion of health care delivery at this level.
Fawole
A O
AO
Department of Obstetrics & Gynaecology, University College Hospital, Ibadan. fawoleo@yahoo.co.uk
Onyeaso
N C
NC
D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use*; D001364:Awareness; D002738:Chloroquine / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D008875:Middle Aged; D009549:Nigeria; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011295:Prenatal Care; D011320:Primary Health Care; D011739:Pyrimethamine / Q000627:therapeutic use; D012938:Social Perception; D011795:Surveys and Questionnaires; D055815:Young Adult
D000962:Antimalarials; D002738:Chloroquine; D011739:Pyrimethamine