Abstract:
Introduction:
Malaria in Tanzania remains the main cause of morbidity and mortality especially in children below five years of age. The resistance of parasite has resulted into frequent changes in antimalarial regimens in Tanzania, however the adherence of health workers in prescribing antimalarials is likely to be affected by this frequent changes of regimen. The extent to which health workers adhere to malaria treatment policy in Tanzania is not clearly documented.
Objective:
The main objective of this study is to assess factors that affect adherence of health workers on malaria treatment policy in public and private health facilities.
Methodology:
An explorative, cross-sectional study was conducted in the health facilities of Singida Rural District. Convenience sampling technique was applied including: semi structured questionnaires with health workers (n=20) and patient exit interviews (n=240). Also direct observation conducted to health workers using checklist for history taking, counselling and prescription.
Results:
Although 75% of health workers received training, only 13.3% found in private health facilities. Nevertheless 63.7% of clinicians showed to be knowledgeable on malaria treatment policy. The results show that availability of varieties of antimalarials influence health workers adherence to malaria treatment policy. ALU reported to be available in both public and private health facilities; 14.3% of ALU blister prepacked according to weight found in FBO health facilities. About 62.9% of exit patients showed to be prescribed ALU for treatment of uncomplicated malaria, and 1.9% of them in private health facilities received ALU. ALU was also prescribed correctly by majority of health workers. However 43.9% of exiting patients received ALU were not given instructions to follow when using ALU. About 76.5% were not told of any possible side effects and about 81.3% did not take their first dose at the facility.
Conclusion and Recommendation
Public-sector health workers have higher knowledge on malaria treatment policy and prescribing practice on recommended antimalarials. Changes in treatment guidelines should be accompanied by subsequent implementation activities involving all sector players in unbiased strategies. Therefore constant supervision should be done to ensure that the policy continues to be effectively implemented.
