Assessment of the process of implementation of intermittent preventive treatment of malaria in pregnancy strategy in Tororo District, Uganda.

Abstract

INTRODUCTION: Malaria in pregnancy is a long known problem in Uganda associated with maternal and child morbidity, mortality and disability. In Uganda, the MOH malaria control strategy mainly focuses on IPT, early diagnosis and treatment and use of insecticide treated nets (ITNs) for prevention of malaria in pregnancy. Implementation of intermittent preventive treatment of malaria in pregnancy in Tororo district started in 2003 but to date no assessment had been conducted to ascertain whether the implementation is as planned. This study’s specific objectives were, assessing the availability, logistics, health workers training, determining the knowledge, attitudes and skills of health workers, data management and monitoring, or implementation of the IPT strategy. METHODOLOGY: This was a descriptive cross sectional study employing quantitative and qualitative data collection methods. It was conducted in Tototo district. The study participants included facility facility health workers, district and health facility managers. RESULTS: The study found out that logistics for implementation of IPT were availability in most health workers. Despite training of health workers being very important for successful implementation of the IPT strategy, of the 145 respondents interviewed 43(29.7%) reported having been trained on the IPT strategy. This study found out that health workers knowledge of implementation of the IPT strategy is good, for example 73.8% and 93.1% of the respondents knew which clients are eligible for IPT1 AAND AIPT2 respectively. Majority of the respondents had good attitudes and were implementing the IPT strategy. RECOMMENDATIONS: The ministry of health should distribute guidelines on implementing of IPT to the district/health facilities. Tororo district should ensure no stock out of SP in all health facilities through planning, adequate budgetary allocation, procurement and distribution of SP. The district should organise orientation, training and refresher courses for health workers on IPT strategy. There should be transfer of health workers between levels of care in the district to have those working at the lower health workers get exposed to services offered at the higher health facilities and vice versa. The district should organise continuing medical education session for health workers on IPT with particular emphasis of IPT in HIV positive mothers. Health workers in the hospitals should be given priority as the proportion of health workers knowledgeable was least in the hospitals. The district and health facility managers should improve completion of ANC register. The district should carry out occasional data validation exercises.