Description
Adherence to Malaria Case Management Guideline in Afar region, Ethiopia, 2023:
Authors: Fentahun Agegnehu1, Kasim Mohammed2, Aman Yesuf2
Email: fentishmw@gmail.com, Kasim.fti@gmail.com, aman.yesuf@sphmmc
Affiliation: St. Paul’s Hospital Millennium Medical College
Abstract
Background: Ethiopia has adapted series of national malaria case management guidelines for effective management of malaria. Few studies have reported sub-optimal adherence to the guidelines in Ethiopia. This study aims to determine the level of adherence to malaria guidelines and associated factors among public and private health facilities in Afar region of Ethiopia.
Methods: A facility based comparative cross-sectional study was conducted among public and private health facilities in Afar region from May 4th to 26th, 2023. Healthcare providers and patient charts were recruited with multistage random sampling. Data were collected using pre-tested questionnaire. A binary logistic regression analysis was applied to assess factors associated with adherence to guideline.
Result: The study involved 334 healthcare providers and patient charts. The overall guideline adherence was 47.3%; CI: 0.41-0.52, 50.9%; CI: 0.41-0.58 in public and 43.7%; CI: 0.36-0.51 in private health facilities, respectively. Public health facility (AOR=3.9; CI: 1.7-9.3) in overall analysis were significant factor for adherence to malaria guideline. Bachelor of Science in Nurse (AOR=3.7; CI: 1.13-12), health centers (AOR=3.73; CI: 1.52-9.23), training (AOR=3.42; CI: 1.53-7.43), availability of guidelines (AOR=3.42; CI: 1.04-11) and supervision (AOR=3.81; CI: 1.62-8.73) were factors associated with guideline adherence in public health facilities. Experience less than two years (AOR=3.71; CI: 1.42-9.23), training (AOR=2.37; CI: 1.12-5.01), job aides (AOR=2.71; CI: 1.24-6.22) and facility supervision (AOR=3.52; CI: 1.23-9.62) were factors associated with guideline adherence in private health facilities.
Conclusion: Adherence to malaria case management guideline was sub-optimal in both public and private health facilities. However, different factors were associated with guideline adherence in each setting. By improving guideline adherence, we can achieve the national goal of malaria elimination. Facility supervision, training, ensuring access and delivery of malaria case management guidelines and job aides would increase the adherence to malaria case management guidelines among public and private health facilities.
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