Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-23T09:41:04.932Z Has data issue: false hasContentIssue false
  • English
  • Français

IMPROVING MALARIA RECOGNITION, TREATMENT AND REFERRAL PRACTICES BY TRAINING CARETAKERS IN RURAL NIGERIA

Published online by Cambridge University Press:  27 November 2009

THEODORA A. OKEKE
THEODORA A. OKEKE
Affiliation:
Department of Community Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria
Get access Rights & Permissions [Opens in a new window]

Summary

A caretaker training programme was carried out in Ugwuogo-Nike, a rural area in south-east Nigeria, based on formative research within the community. A training of trainers workshop was organized for 30 leaders of women groups who subsequently trained other mothers in their group. Community information activities, which lasted for a period of eight months, included the use of posters, drama group and jingles. The programme was evaluated using the quantitative and qualitative methods that were employed at baseline, which included community survey and focus group discussions (FGDs). For the community survey, households with children under five years of age were identified and provided the sampling frame, from which 300 households were chosen using the systematic sampling method. The target population for the FGDs were caretakers of children under five years. Post-intervention evaluation of the programme showed significant (p<0.05) improvements in knowledge, home management of malaria and referral practices for severe malaria. Those who correctly reported that mosquitoes were the cause of malaria rose markedly from 39.7% to 88.7%. Knowledge of symptoms of mild and severe malaria also increased significantly. Only 1.5% of caretakers were aware of the correct dose of anti-malarial before intervention, but this increased to 41.5%. The impact of intervention brought about a dramatic change in the practice of taking severely ill children, especially those with convulsion, to a traditional healer. A minority (6.7%) of caretakers took a severely ill child to a traditional healer as against 60% pre-intervention. There was also a significant increase in use of formal health facilities for the treatment of severely ill children. The study findings support the view that training of mothers to recognize, treat appropriately and refer severe cases of malaria is feasible and may lead to a reduction in the incidence of severe disease.

Type
Research Article
Information
Journal of Biosocial Science , Volume 42 , Issue 3 , May 2010 , pp. 325 - 339
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adome, R. O., Hardon, A. & Reynolds-Whyte, S. (1996) Popular Pills: Community Drug Use in Uganda. Het Spinhuis, Amsterdam.Google Scholar
Agyepong, I. A. (1992) Malaria: ethnomedical perceptions and practices in an Adangbe farming community and implications for control. Social Science and Medicine 35, 131–137.CrossRefGoogle Scholar
Breman, J. G. & Campbell, C. C. (1988) Combating severe malaria in African children. Bulletin of the World Health Organization 66, 611–620.Google ScholarPubMed
Derming, A. (1993) Community participation in disease control. Social Science and Medicine 36, 1145–1150.Google Scholar
Derming, M. S. et al. (1989) Home treatment of febrile children with antimalarial drugs in Togo. Bulletin of the World Health Organization 67, 695–700.Google Scholar
Ejezie, G. C., Ezedinachi, E. N., Usanga, E. A., Gemade, E. I., Ikpatt, N. W. & Alaribe, A. A. (1990) Malaria and its treatment in rural villages of Aboh Mbaise, Imo State, Nigeria. Acta Tropica 48, 17–24.CrossRefGoogle ScholarPubMed
Federal Ministry of Health (2000) Situation Analysis of Malaria Control in Nigeria. Federal Ministry of Health, Abuja, Nigeria.Google Scholar
Federal Ministry of Health (2005) Federal Republic of Nigeria National Antimalarial Treatment Policy. Federal Ministry of Health, Abuja, Nigeria.Google Scholar
Foster, S. D. (1991) Princing, distribution and use of anti-malaria drugs. Bulletin of the World Health Organization 69, 349–363.Google Scholar
Foster, S. D. (1995) Treatment of malaria outside the formal health services. Journal of Tropical Medicine and Hygiene 98, 29–34.Google ScholarPubMed
Gomes, M., Wayling, S. & Pang, L. (1989) Interventions to improve the use of antimalarials in Southeast Asia: an overview. Bulletin of the World Health Organization 76, 9–20.Google Scholar
Greenwood, B. M., Bradely, A. K., Bypass, P. et al. (1987) Mortality and morbidity from malaria among children in a rural area of Gambia, West Africa. Transaction of the Royal Society for Tropical Medicine and Hygiene 81, 478–486.CrossRefGoogle Scholar
Hamel, M. J., Odhacha, A., Roberts, J. M., & Deming, M. S. (2001) Malaria control in Bungoma District, Kenya: a survey of home treatment of children with fever, bednet use and attendance at antenatal clinics. Bulletin of the World Health Organization 79, 1014–1023.Google Scholar
Hassouna, W. A. (1983) Reaching the people; a three country study of health system. World Health Forum 4, 57–62.Google Scholar
Igun, U. A. (1987) Why we seek treatment here: retail pharmacy and clinical practice in Maiduguri, Nigeria. Social Science and Medicine 24, 689.CrossRefGoogle ScholarPubMed
Kidane, G. & Morrow, R. H. (2000) Teaching mothers to provide home treatment of malaria in Tigray, Ethiopia: a randomized trial. Lancet 356, 550–555.CrossRefGoogle Scholar
Kroeger, A. (1983) Anthropological and socio-medical health care research in developing countries. Social Science and Medicine 17, 147–161.CrossRefGoogle ScholarPubMed
McCombie, S. C. (2002) Self treatment for malaria: the evidence and methodological issues. Health Policy and Planning 14, 333–344.Google Scholar
Mwenesi, H. A. (1993) Mother's definition and treatment of childhood malaria on the Kenya Coast. PhD Dissertation, London School of Hygiene and Tropical Medicine, University of London.Google Scholar
Mwenesi, H., Harpham, T. & Snow, R W. (1995) Child malaria treatment among mothers in Kenya. Social Science and Medicine 40, 1271–1277.CrossRefGoogle ScholarPubMed
Oshiname, F. O. & Brieger, W. R. (1992) Primary care training for patent medicine vendors in rural Nigeria. Social Science and Medicine 35, 1477–1484.CrossRefGoogle ScholarPubMed
Ramakrishna, J., Brieger, W. R. & Adeniyi, J. D. (1989) Treatment of malaria and febrile convulsions: an educational diagnosis of Youruba beliefs. International Quarterly of Community Health Education 9, 305–319.CrossRefGoogle Scholar
Ruebush, T. K., Kern, M. K., Campbell, C. C. & Aloo, A. J. (1995) Self-treatment of malaria in a rural area of western Kenya. Bulletin of the World Health Organization 73, 229–236.Google Scholar
Sauerborn, R., Nougtara, A. & Diesfeld, H. J. (1989) Low utilization of community health workers: results from a household interview survey in Burkina Faso. Social Science and Medicine 29, 1163–1174.CrossRefGoogle ScholarPubMed
Slutsker, L., Chitsulo, L., Macheso, A. & Steketee, R. W. (1994) Treatment of malaria fever episodes among children in Malawi; results of a KAP survey. Tropical Medicine and Parasitology 45, 61–64.Google ScholarPubMed
Snow, R. W., Craig, M., Deichmann, U. & Marsh, K. (1999) Estimating mortality, morbidity and disability due to malaria among Africa's non-pregnant population. Bulletin of the World Health Organization 77, 624–640.Google ScholarPubMed
Snow, R. W., Peshu, N., Forster, D., Mwenesi, H. & Marsh, K. (1992) The role of shops in the treatment and prevention of childhood malaria on the coast of Kenya. Transactions of the Royal Society of Tropical Medicine and Hygiene 86, 237–239.CrossRefGoogle ScholarPubMed
Van der Geest, S. (1987) Self-care and the informal sale of drugs in South Cameroon. Social Science and Medicine 25, 293–305.CrossRefGoogle ScholarPubMed
White, N. (1999) Antimalarial drug resistance and combination chemotherapy. Philosophical Transactions of the Royal Society of London B 354, 739–749.CrossRefGoogle ScholarPubMed
Winch, P. J., Makemba, A. M., Kamazima, S. R., Lurie, M., Lwihula, G. K., Premji, Z., Minjas, J. N. & Shiff, C. J. (1996) Local terminology for febrile illnesses in Bagamoyo district, Tanzania and its impact on the design of a community based malaria control programme. Social Science and Medicine 42, 1057–1067.CrossRefGoogle ScholarPubMed
WHO (2000) Expert Committee on Malaria Twentieth Report. Technical Report Series No. 892, WHO, Geneva.Google Scholar
WHO (2003) Country Strategies and Resource Requirement. URL: http://mosquito.who.int/docs/sstrategy/nigeria.htmGoogle Scholar
WHO/RBM (2000) Framework for Monitoring Progress and Evaluating Outcomes and Impact. WHO/CDS/RBM, Geneva.Google Scholar