Intermittent preventive therapy and treatment of malaria during pregnancy: Perspectives of health care providers in Rufiji district, southern Tanzania

Abstract

Objectives : The aim of this study was to assess the level of knowledge of the health care providers on malaria prevention and treatment guidelines in pregnant women. Facility assessment was also carried out to find out if the current health system supports the performance of the health care providers for implementation of the national treatment guidelines. Methods : This was a facility based descriptive cross sectional study, which was carried out in Rufiji district, Southern Tanzania. Cluster sampling technique was used to randomly select 14 health facilities which provide antenatal care in the district. Health care providers working at the antenatal clinics in the selected facilities were recruited for the study. Knowledge of health care workers was assessed using self-administered questionnaires and a checklist was used for assessment of the health facilities. Results : Out of 22 interviewed health care providers, 17 had high level of knowledge on the use of sulphadoxinepyrimethamine (SP) for intermittent preventive therapy (IPT) of malaria in pregnancy, and the rest (5) had medium level of knowledge. With regards to the use of artemether-lumefantrine (ALu) during pregnancy, 9 health care providers had medium knowledge and the rest (13) had low level of knowledge. Frequent stock out of SP and ALu, inadequate malaria diagnostic facilities and shortage of trained health care providers were the major factors contributing to ineffective implementation of malaria treatment and prevention guidelines in pregnant women in the health facilities. Conclusion : For effective implementation of IPT policy and treatment of malaria during pregnancy, health care providers must be well educated, mentored and supervised to ensure rational use of antimalarial drugs especially in pregnant women. Strategies should be devised to ensure constant availability of malaria diagnostic tools and antimalarial drugs at the health facilities. Key words : Intermittent preventive therapy, pregnant women, artemether-lumefantrine, malaria, health facilities