Factors infuencing health workers’ compliance with the WHO intermittent preventive treatment for malaria in pregnancy recommendations in the Northern Region, Ghana
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Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Malaria Journal
Abstract
Background: Although IPTp-SP is a lifesaving World Health Organization (WHO) recommended preventive interven tion for pregnant women in malaria-endemic regions, IPTp-SP uptake in the Northern region of Ghana is much lower
than the sub-optimal national coverage level. Assessing the extent of health workers’ compliance and its associated
factors will generate valuable pointers to be targeted at the program level. The study examined the factors infuenc ing health workers’ compliance with the WHO recommended guidelines for IPTp-SP in the Northern Region.
Methods: A cross-sectional study among 315 health workers in the Northern region was conducted. Semi-structured
questionnaires were used to collect data on health workers’ sociodemographic characteristics, facility-based factors
and knowledge level. Data were collected on health workers’ compliance with the recommended practices through
covert observations using a checklist. Facility observations were carried out using a checklist. Crude and adjusted
logistic regression were used to determine predictors of health workers’ compliance, at a 5% signifcance level adjust ing for clustering.
Results: Of the 315 health workers studied, the median age was 29 years (26–34 years). Females constituted
(80.5%; 252) of the 313 workers. The majority (47.4%;148) of the 312 health workers were midwives. Overall, 56.2%
(CI 51.0 – 62.0) were adequately complying with the recommended guidelines. Lower levels of compliance were
recorded in health centres 15.6% (5.0 – 33.0) and CHPS compounds 21.2% (11.0 – 35.0). The factors associated with
compliance included health workers’ knowledge (aOR=7.64, 95% CI 4.21 – 13.87, p<0.001), job satisfaction (aOR
10.87, 95% CI 7.04 – 16.79, p<0.001), in-service training (aOR 10.11, 95% CI 4.53 – 22.56, p<0.001), supervision (aOR
4.01, 95% CI 2.09 – 7.68, p<0.001), availability of job aids (aOR 3.61, 95% CI 2.44 – 5.35, p<0.001), health workers expe rience (aOR=10.64, 95% CI 5.99 – 18.91, p<0.001) and facility type (aOR 0.03, 95% CI 0.01–0.07, p<0.001). Conclusion: Compliance with the recommended IPTp-SP guidelines is suboptimal in the region, with lower-level
health facilities recording the least compliance levels. Health centres and CHPS facilities should be prioritized in dis tributing limited resources to improve health worker quality of care for antenatal care clients
Description
Research Article
Keywords
Compliance, Health workers, IPTp-SP, Ghana