Assessment of quality of malaria care in pregnancy at Mkuranga district hospital

Abstract

A descriptive cross- sectional study was conducted in May 2002, at Mkuranga District Hospital. The aim of the study was to assess different aspects of quality of malaria care in pregnancy with emphasis on infrastructure input, the process of provision of malaria care to pregnant women and its impact. In addition the impacts were assessed in terms of pregnant women's knowledge of the causes of malaria, prevention and treatment. The study comprised of 282 pregnant women and 8 clinicians. All of the pregnant women studied were peasants with absolute age range of 14 to 40 years old. Structured questionnaires were used to collect information from both clinicians and pregnant women. A checklist with a number of items was used to assess the availability of resources, such as human resources, physical infrastructure and ,/equipments. The major findings of the study were as follows: - Majority of pregnant women interviewed (92.3%) knew that mosquito's transmits malaria. About 61 % of pregnant women mentioned Insecticide Treated bed nets as one of the most effective method of malaria prevention at household level. While about 87% of pregnant women prefer to seek Hospital care once they suspect malaria infection, and few reported to seek malaria care from traditional healers and self- medication. However, the majority had little awareness about common complications of malaria in pregnancy. Majority (90%) had positive feelings about communication between them and health care providers. Deficiencies were recorded in relation to the size of the hospital buildings and staffing levels of different hospital cadres. The hospital buildings were found to be too small to accommodate a district Hospital. With regard to staffing level, the most affected cadre was the lower level cadre of nurses and medical assistants with a shortage amounted to 82% deficit. The study further found that clinicians had no proper protocols for malaria diagnosis and treatment; neither followed the National Guidelines for malaria management in pregnancy. This study concludes that, there are deficiencies in various aspects of "quality of malaria care in pregnancy. Most of the problems identified are due to the , fact that the District is newly established. However recommendations for improvement of the situation are provided.