Perception and Practice of Malaria Prophylaxis in Pregnancy among Health Care Providers in Ibadan

Abstract

The study assessed knowledge and practice of health care providers on current concepts on malaria prophylaxis in pregnancy. 497 randomly selected respondents at the three levels of care in two local governments in Ibadan, South western Nigeria were interviewed using a self-administered questionnaire. Respondents were selected from 45 health facilities: 48 (9.7%) community health extension workers (CHEWS), 139 (28.9%) auxiliary nurses, 220 (44.3%) formally trained nurses and 90 (18.10%) medical doctors. Only 57 (11.5%) respondents were knowledgeable about current WHO strategies for malaria prevention in pregnancy. Three hundred and eighty six respondents (77.7%) were aware of intermittent preventive treatment (IPT). Awareness about IPT was highest among CHEWS (95.8%). Pyrimethamine was prescribed mainly by healthcare providers in the secondary (60.6%) and primary (60.3%) levels of care (chi2 = 11.54, p < 0.01). Chloroquine was prescribed by 42.5% of respondents. Sulfadoxine-pyrimethamine was significantly more commonly prescribed by primary health care providers than in other levels of care (chi2 = 15.07, p < 0.01). Prescription for insecticide treated nets was high. Respondents' practice of anti-malarial chemoprophylaxis was influenced by the cadre of the health care provider and level of practice. There are several knowledge gaps on current malaria prevention strategies in pregnancy among healthcare providers. Multiple strategies are required to improve health care workers' knowledge and practice of malaria prevention during pregnancy.