An Investigation Into Adherence to Arthemisinin Combination Theraphy (ACTs) Prescription Guidelines Based on Parasitological Confirmation Before Treatment of Malaria:

Abstract

Introduction: This study investigated level of adherence to the recommended Arthemisinin Combination Therapy (ACTs) prescription guidelines and factors that influence adherence to the guidelines in the management of malaria in health facilities in Apac District. This was in view of the fact that the prescription practices of the health workers investigated in earlier studies appear not to have changed, despite the various strategies of dissemination exercise of these guidelines by MoH to clinicians throughout the country.

Objectives: The study had three specific objectives that is to determine level of adherence among health workers to ACT prescription guidelines; to identify health worker factors influencing adherence to ACTs guidelines, and to establish health facility factors influencing adherence to ACTs guidelines based on parasitological confirmation before treatment of malaria in health facilities in Apac district.

Methodology: The study was conducted using a cross-sectional survey design. Data was collected using document reviews from outpatients records of fever, laboratory tests for malaria and ACTs prescription records for the months of April, May and June, to establish level of adherence; focus group discussions, key Informant interviews and self-administered questionnaires to establish other factors affecting adherence to ACTs guidelines. Data was analyzed using SPSS and Epi-info and presented using descriptive statistics of percentages and frequencies. The chi-square test was used to establish the significance of differences in levels of adherence.

Findings: Documents review from health facility records in the district revealed low levels of adherence to ACTs prescription guidelines at the different health facilities studied, in the months of April, May and June, 2014.

Conclusions and recommendations: The study revealed that level of adherence to ACTs guidelines based on parasitological confirmed test before treatment of malaria is generally low in Apac district. Therefore MoH should plan new strategies to be used in enforcement of the policy implementation in order to achieve the benefits of adherence to the ACTs prescription guidelines based on parasitology as recommended by WHO.