Prescribers’ adherence to Malaria diagnosis and treatment guideline and associated factors in Kinondoni public health facilities, Dar es salaam

Abstract

ABSTRACT Background: Malaria remains a major global health issue, particularly in high-prevalence areas like Tanzania, contributing significantly to morbidity and mortality. Despite established guidelines advocating for diagnostic confirmation before prescribing antimalarial drugs, adherence to these protocols is often poor. Objective: To assess prescriber adherence to malaria diagnosis and treatment guideline and associated factors in Kinondoni public health facilities, Dar es Salaam. Methods: This process evaluation adopted a descriptive cross-sectional study design was conducted, employing a quantitative method. A total of 135 participants were involved. Data (Demographic characteristics, Prescriber adherence, Operational factors, and patient influence) were analyzed using SPSS Version 20. Results: Significant factors affecting adherence to malaria guidelines were identified. Clinical officers exhibited the highest strict adherence (77.3%) compared to assistant medical officers (13.6%) and medical doctors (9.1%) with a p-value of 0.03. Hospitals had partial adherence (86.7%) and no strict adherence (0.0%), also with a p-value of 0.03. Prescribers with 2 years or less experience showed 50.0% strict adherence, while those with 3-5 years had 35.0%, resulting in a p-value of 0.04. Operational factors, especially training availability, had a significant impact on adherence (p-value of 0.02). Patient demand for malaria treatment also played a role, with a p-value of 0.01. Conclusion: The findings of this study demonstrate significant adherence to malaria treatment guidelines is influenced by prescriber type, experience, facility type, and patient demand. Clinical officers showed the highest strict adherence, while variations of adherence among different levels of professionals across health facilities call for targeted interventions, and aligning community expectations with clinical practices is crucial for improving adherence. Recommendation: The health facility manager should introduce regular training programs and update guidelines for prescribers. Additionally, engaging with community health workers to manage patient expectations will enhance adherence and improve health outcomes.