FACTORS INFLUENCING MALARIA TREATMENT AND PATIENT ADHERENCE TO ANTIMALARIAL DRUGS IN SOUTHERN ETHIOPIA

K D Gidebo; Thandisizwe Redford Mavundla; T E Masango

doi:10.25159/2520-5293/39

Authors

K D Gidebo Wolaita Sodo University
Thandisizwe Redford Mavundla Department of Health Studies University of South Africa
T E Masango

DOI:

https://doi.org/10.25159/2520-5293/39

Abstract

In Ethiopia the health system is underdeveloped and much of the rural population has limited access to modern health services. The Ethiopian government introduced the Health Extension Program which is a community-based health care delivery system aimed at accessing essential health services such as malaria treatment through its health extension workers (HEWs). The objective of this study was to evaluate factors influencing malaria treatment practice of health extension workers (HEWs) and patient adherence to antimalarial drugs. A qualitative research design that is explorative and descriptive was used. Data was collected by means of (1) in-depth individual interviews among 20 HEWs, and seven focus group discussions with malaria treated patients. Data was analyzed thematically. Four themes emerged from the data, namely: (1) health facility related factors, (2) HEWs related factors, (3) patient related factors, and (4) community related factors. Improving the availability of essential resources such as rapid diagnostic test kits (RDT) and antimalarial drugs, improving the communityâ€™s perception towards antimalarial drug effectiveness and adequately educating patients on how to take antimalarial drugs can improve malaria treatment practice of the HEWs and patient adherence to antimalarial drugs.

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References

Addis Continental Institute of Public Health. 2009. Qualitative study on malaria prevention and control in Oromia and Amhara regional states in Ethiopia. Addis Ababa: ACIPH (Unpublished document).

Argaw, H. 2007. The health extension program of Ethiopia. Summary of concepts, progress, achievements and challenges. Addis Ababa: WHO Country Office Of Ethiopia.

Barnabas, GA. 2009. Community deployment of coartem in Tigray, northern Ethiopia. In: NMCP 7th Best Practice Sharing Workshop. June 10th-11th 2009. Hotel Iâ€™Amitie, Bamako: Mali.

From: http://www.trhb.gov.et/profiles/Community%20Deployment.pdf (accessed 9 December 2010).

Beer, N, Ali, AS, Rottlant, G, Abass, AK, Omari, RS, Al-mafazy, AH, Rkman, AB & Ilander. 2009. Adherence to artesunate-amodiaquine combination therapy for uncomplicated malaria in children in Zanzibar, Tanzania. Tropical Medicine and International Health 14(7):766-774. DOI: https://doi.org/10.1111/j.1365-3156.2009.02289.x

Boonstra, E, Lindback, M, Khulumani, P, Ngome, E & Fugeh, P. 2002. Adherence to treatment guidelines in primary health care facilities in Botswana. Tropical Medicine and International Health 4(2):178-186. DOI: https://doi.org/10.1046/j.1365-3156.2002.00842.x

Collins English Dictionary. 1991. Sv â€œadherenceâ€. 3rd edition. Glasgow: Harper Collins.

Conteh, L, Stevens, W & Wiseman, V. 2007. The role of communication between clients and health care providers. Implications for adherence to malaria treatment in rural Gambia. Tropical Medicine and International Health 12:382-391. DOI: https://doi.org/10.1111/j.1365-3156.2006.01806.x

Creswell, JW. 2009. Research design. Qualitative, quantitative, and mixed methods approaches. 3rd edition. London: Sage.

Ethiopian Federal Ministry of Health. 2003. Malaria health extension package. Addis Ababa: EFMOH.

Ethiopian Federal Ministry of Health. 2005. Basic concepts of health extension package. Addis Ababa: EFMOH.

Ethiopian Federal Ministry of Health. 2010. National strategic plan for malaria prevention, control and elimination in Ethiopia 2010-2015. Addis Ababa: EFMOH.

Jima, D, Getachew, A, Bilack, H, Steketee, RW, Emerson, PM, Graves, PM, Gebre, T, Reithinger, R & Hwang, J. 2010. Malaria indicator survey 2007, Ethiopia: Coverage and use of major malaria prevention and control interventions. Malaria Journal 9:58. DOI: https://doi.org/10.1186/1475-2875-9-58

Kachur, SP, Khatib, RA, Kaizer, E, Fox, SS, Abdulla, SM & Bloland, PB. 2004. Adherence to antimalarial combination therapy with sulfadoxine-pyrimethamine and artesunate in rural Tanzania. American Journal of Tropical Medicine and Hygiene 71(6):715-722. DOI: https://doi.org/10.4269/ajtmh.2004.71.715

Kamat, VR & Nyato. 2010. Community response to artemisinin-based combination therapy for childhood malaria: a case study from Dares Salaam, Tanzania. Malaria Journal 9:61. DOI: https://doi.org/10.1186/1475-2875-9-61

Kokwaro, G, Mwai L, Nzila A. 2007. Artemether Lumefantrine in the treatment of uncomplicated falciparum malaria. Informa Health care. Expert Opinion Pharmacotherapy 8(1):75-94. DOI: https://doi.org/10.1517/14656566.8.1.75

Lincoln, YS & Guba, EG. 1985. Naturalistic enquiry. Beverly Hills: Sage. DOI: https://doi.org/10.1016/0147-1767(85)90062-8

Meremikwu, M, Okomo, U, Nwachukwu, C, Oyo-Ita, A, Eke-Njoku, J, Oyo-Ita, E & Garner, D. 2007. Antimalarial drug prescribing practice in private and public health facilities in south east Nigeria: a descriptive study. Malaria Journal 6:55. From: http://www.malariajournal.com/content/6/1/55 (accessed 16 July 2012). DOI: https://doi.org/10.1186/1475-2875-6-55

Rowe, AK, Savigny, D, Lanata, CF & Victoria, CG. 2005. How can we achieve and maintain high quality performance of heath worker in low-resource settings? Lancet 366:1026-1035. DOI: https://doi.org/10.1016/S0140-6736(05)67028-6

Unni, EJ. 2008. Development of models to predict medication non-adherence based on a new typology. Unpublished Dissertation. University of Iowa, Iowa.

Walter, ND, Lyimo, T, Skarbinski, J, Metta, E, Kahigwa, E, Flannery, B, Dowell, SF, Abdulla, S & Kachur, SP. 2008. Why first-level health workers fail to follow guidelines for managing sever diseases in children in the coast region, the united republic of Tanzania. Bulletin of the World Health Organization 87:99-107. From: http://www.who.int/bulletin/volumes/87/2/08-050740/en/# (accessed 13 September 2011). DOI: https://doi.org/10.2471/BLT.08.050740

Wasunna, B, Zurovac, D, Goodman, CA & Snow, RW. 2008. Why donâ€™t health workers prescribe ACT? A qualitative study of factors affecting the prescription of artemetyher-lumefantrine. Malaria Journal 7:29. DOI: https://doi.org/10.1186/1475-2875-7-29

World Health Organization. 2004b. World malaria report. Geneva: WHO. From: http://www.who.int/whr/2004/en/report04-en.pdf (accessed 10 September 2012).

World Health Organization. 2003 Adherence to long term therapies. Evidence for action. Geneva: WHO.

World Health Organization. 2006. Guidelines for the treatment of malaria. WHO publications.

From:http://www.who.int/malaria/docs/TreatmentGuidelines2006.pdf (accessed 12 March 2011).

World Health Organization. 2010. Guidelines for treatment of malaria. 2nd edition.