Malaria treatment perceptions, practices and influences on provider behaviour: comparing hospitals and non-hospitals in south-east Nigeria.
BACKGROUND
People seek treatment for malaria from a wide range of providers ranging from itinerant drug sellers to hospitals. However, there are lots of problems with treatment provision. Hence, factors influencing treatment provision in hospitals and non-hospitals require further investigation in order to remedy the situation.


OBJECTIVE
To examine the knowledge, pattern of treatment provision and factors influencing the behaviour of hospitals and non-hospitals in the treatment of malaria, so as to identify loci for interventions to improve treatment of the disease.


METHODS
A pre-tested structured questionnaire was used to collect data from 225 providers from hospitals and non-hospitals about their malaria treatment practices and factors that influence their provision of malaria treatment services in south-east Nigeria. The data from hospitals and other providers were compared for systematic differences.


RESULTS
73.5% of hospitals used microscopy to diagnose malaria and only 34.5.1% of non-hospitals did (p < 0.05). Majority of the respondents considered ability to pay bills (35.2%), already existing relationship (9.4%) and body mechanism (35.2%) of the patient before they provided malaria treatment services. Pressure from wholesalers to providers to repay the cost of supplied drugs was the major influence of the type of drugs provided to patients.


CONCLUSIONS
There are many challenges to appropriate provision of malaria treatment services, although challenges are less in hospitals compared to other types of non-hospitals. Improving proper diagnosis of malaria and improving the knowledge of providers about malaria are interventions that could be used to improve malaria treatment provision.
Onwujekwe
Obinna
O
Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu, Nigeria. onwujekwe@yahoo.co.uk
Uzochukwu
Benjamin
B
Dike
Nkem
N
Uguru
Nkoli
N
Nwobi
Emmanuel
E
Shu
Elvis
E
D000962:Antimalarials / Q000600:supply & distribution / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003153:Community Health Services / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D009549:Nigeria; D010818:Practice Patterns, Physicians'; D012938:Social Perception; D011795:Surveys and Questionnaires
D000962:Antimalarials