Adherence to laboratory test results in the management of malaria in KCCA health centers in Kampala city, Uganda.

Abstract

Introduction: This study aimed at assessing the levels of adherence to laboratory test results in the management of malaria in KCCA health centers in Kampala City, Uganda. This was on the basis of the facts that the prescription practices of health workers in malaria management investigated in earlier studies appeared not to have changed despite the various strategies on dissemination exercise of these guidelines and policy by Uganda MoH.

Objectives: The study had three specific objectives; To determine the level of adherence by health workers to laboratory test results in the management of malaria, to identify health worker factors affecting adherence to laboratory test results in the management of malaria, and to identify the health facility factors affecting adherence to laboratory test results in the management of malaria in KCCA health centers in Kampala City, Uganda.

Methodology: Cross-sectional survey design was adopted for this study. Secondary data was collected using documents review from outpatient’s records, laboratory test for malaria and Acts prescription records for the month of June, July and August, 2015 to establish level of adherence in the health centers. Primary data was collected using self-administered questionnaires, focus group discussions and key informant interviews to establish other factors affecting adherence to laboratory test results in the management of malaria following the WHO/ MoH policy guidelines. Data was analyzed using Epi-data and SPSS which was presented using descriptive statistics of frequencies and percentages. The chi-square test was used as bivariate analysis to test the level of association between the variables of the study while logistic regression was used as multivariate analysis to determine the influence of the independent variables on the dependent variable.

Findings: Documents reviewed from the health centers revealed low levels of adherence to laboratory test results in the management of malaria during the months of June, July and August, 2015. Findings from this study revealed that of the 15,169 patients treated with ACTs in the health centers, up to 13,309(87.7%) were either malaria negative or not tested. The level of compliance to WHO/UNMCP malaria treatment guidelines was only 12.3% which is very low. There is significant association between; Awareness of the policy (χ2 = 7.759, p = 0.008, and AOR = 4.307), Health worker attitudes (χ2 = 9.041, p = 0.029 and AOR = 0.415) and Results delivery time (χ2 = 13.650, p = 0.000 and AOR = 6.884) on the dependent variable.

Conclusion and Recommendations: The study revealed that adherence to laboratory test results in the management of malaria in KCCA health centers, Kampala City as generally low. Therefore MoH and KCCA should plan new strategies that should be used to ensure policy implementation in order to achieve the benefit of adherence to laboratory test results in the management of malaria as recommended by WHO.