Adherence to the Administration Guidelines of Seasonal Malaria Chemoprevention by Caregivers in the Tamale Central District

Abstract

Background: In developing countries including Ghana, malaria continues to be a major cause of morbidity and mortality, especially in children below five years. The World Health Organization (WHO) introduced Seasonal Malaria Chemoprevention (SMC) as an additional strategy to strengthen malaria control. The intervention is very effective in the prevention of clinical episodes of malaria in children but not without adherence to the administration protocols. This study examines the factors that are associated with adherence to SMC among caregivers in the Tamale Central District. Objective: To assess the factors influencing adherence to Seasonal Malaria Chemoprevention (SMC) administration guidelines by caregivers in the Tamale Central District. Methods: The study approach used was cross-sectional, conducted in four (4) subdistricts in the Tamale Central District. Eight (8) communities were selected through simple random sampling. A total of 471 caregivers from households were randomly sampled by balloting to participate in the study. Knowledge of malaria and awareness of the benefits of SMC was assessed by scoring correct answer questions from multiple choice questions related to malaria and SMC. We used close-ended questions to assess community health volunteer factors. Pearson Chi-square test was used to test the association between adherence to SMC and the predictor variables. Multiple logistic regression analysis was performed to examine the strength of the associations between adherence to SMC and the predictor variables and the results were interpreted at a 95% confidence level. Results: The study obtained an SMC adherence rate of 90.9%. Forgetfulness (62.5%) was the main reason for missing SMC doses. Overall knowledge of caregivers on malaria was low at 71.1%, moderate at 26.5%, and high at.3%. About 85% of respondents were aware of the benefits of SMC. The factors that were significantly related to adherence in the multiple logistic regression model were educational background, knowledge of malaria, source of information on SMC, and satisfaction level of caregivers. Conclusion: The adherence rate of SMC in the Tamale Central District is 90.9%. The result from the study reveals that having secondary and tertiary education, those who reported the child refused to play as the effects of malaria, those who use mosquito coil as a way of preventing a child from malaria, those whose source of information on SMC is from friends, and those who are happy with SMC, were significantly associated with adherence to SMC.