Knowledge, Attitude And Practice Of Pregnant Women Toward Prevention And Control Of Malaria In UCTH

Project and Seminar Material for Nursing (Science)

Abstract

This study was carried out to assess the knowledge, attitude and practice of pregnant women toward prevention and control of malaria in University of Calabar Teaching Hospital. The study was specifically carried out to determine the knowledge of pregnant women about malaria prevention and control, examine the attitude of pregnant women about malaria prevention and control and identify the practice used in malaria prevention and control among pregnant mothers attending ANC at University of Calabar Teaching Hospital. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of pregnant women attending ANA in University of Calabar Teaching Hospital. In determining the sample size, the researcher purposefully selected 41 respondents and 35 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables. While the hypotheses were tested using Chi-square statistical tool. The result of the findings reveals that pregnant women attending ANA in University of Calabar Teaching Hospital have adequate knowledge about malaria prevention and control. Furthermore, the findings showed that to prevention and control malaria, pregnant women attending ANC at University of Calabar Teaching Hospital make effective use of mosquito net, ensure indoor residual spraying, makes use of antimalarial prophylaxis, spray insecticides, and use traditional medicine. Therefore, it is recommended that the ministry of health should continue community support in malaria prevention like distribution of free insecticide treated mosquito nets. To mention but a few.

Table of Content

Title Page
Certification
Dedication
Acknowledgement
Table of Content
List of Tables
Abstract

Chapter One:

Introduction

1.1 Background of the Study
1.2 Statement of the Problem
1.3 Objective of the Study
1.4 Research Questions
1.5 Research Hypothesis
1.6 Significance of the Study
1.7 Scope of the Study
1.8 Limitation of the Study
1.9 Definition of Terms
1.10 Organisations of the Study

Chapter Two:

Review of Literature

2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review

Chapter Three:

Research Methodology

3.1 Research Design
3.2 Population of the Study
3.3 Sample Size Determination
3.4 Sample Size Selection Technique and Procedure
3.5 Research Instrument and Administration
3.6 Method of Data Collection
3.7 Method of Data Analysis
3.8 Validity of the Study
3.9 Reliability of the Study
3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

4.1 Data Presentation
4.2 Analysis of Data
4.3 Answering Research Questions
4.4 Test of Hypotheses

Chapter Five:

Summary, Conclusion and Recommendation

5.1 Summary
5.2 Conclusion
5.3 Recommendation
References
APPENDIX
QUESTIONNAIRE

Chapter One

Introduction

1.1 Background of the Study

Malaria, a serious public health problem especially in most developing countries affects people living in tropical and sub-tropical areas (Snow et al., 1999). A deadly parasitic disease caused by infection with Plasmodium. Malaria disease imposes serious effect on the blood by interfering with hemoglobin and destroying red blood cells (WHO, 2003).Malaria poses tremendous public health problems across the globe with estimated 600,000 – 1,000,000 deaths attributed to it. Mortality is especially high in people not adequately protected by an acquired immunity, such as young children, pregnant women and migrants (WHO, 2013). In Africa, an estimated 10,000 pregnant women and 200,000 infants die as a result of malaria in pregnancy, Studies have shown that malaria worsens certain pregnancy outcomes that include, increased incidence of anaemia, spontaneous abortions, inter uterine growth restrictions, still birth, low birth weight, fetal distress and congenital malaria (Rogerson et al., 2007). Nigeria is known for high prevalence of malaria where at least 50 % of its population suffers from at least one episode of malaria each year accounting for over 45 % of all outpatient visits (Iriemenam et al., 2011).

Regarding problems associated with malaria in pregnancy, the World Health Organization (WHO, 2001) has adopted a three pronged approach for reducing malaria burden among pregnant women. These approaches include, effective case management of malaria infection, the use of insecticide treated nets and intermittent preventive treatment in areas of stable transmission. The knowledge of how these strategies work in the population together with the identification of main determinants that influence protective behaviours among pregnant women are required to monitor and evaluate the progress of the malaria control efforts. Insufficient knowledge on the contributory factors to malaria justifies the study and therefore serves to educate pregnant women of the effects on maternal and neo-natal health and possible prevention and control measures in curbing the menace.

1.2 Statement of the Problem

Each year, more than 30 million women in Nigeria and malaria endermic areas become pregnant and are at risk of infection with Plasmodium falciparum. This results to high prevalence of patent parasitaemia and clinical malaria in pregnancy2. In Nigeria, past studies reported malaria parasite prevalence of between 60% and 72% among pregnant women3. Malaria during pregnancy caused up to 10,000 maternal deaths each year and contributes to high rate of maternal morbidity including fever and severe anaemia, especially in first time mothers2. A recent study estimated that malaria contributes to 3-5% of maternal anaemia, 8-14% of low birth weight and 3-8% of infant mortality4. The harmful impact of malaria is most apparent to the first and second pregnancies of most pregnant women living in areas of relatively stable transmission5. Knowledge of malaria prevention during pregnancy is relatively high as malaria is perceived as a serious illness. Contact with traditional healers and self medication is a common feature in African societies. Most pregnant women lack knowledge about the causative factors of malaria as they attribute the infection to be caused by living in an unclean environment, eating of oily food, poisoned food and witchcraft.

A study reported that the practice of malaria preventive measures among pregnant women is not encouraging as their use of insecticide treated bed nets is unacceptably low and this contributes to high infection rates. The pregnant women’s knowledge and practice of intermittent preventive treatment (IPTP) is poor as the majority of women do not know sulpadoxine – pyrimethamine (SP) as the drug recommended for IPTP and are not aware that IPTP could be given to pregnant women7.

Prevention of malaria in pregnancy is a major priority for the roll back malaria partnership. In high transmission areas including Nigeria, the roll back malaria partnership recommends a three pronged approach for reducing the burden of malaria among pregnant women, which are; effective case management of malaria infection, use of insecticide treated nets (ITNS) and intermittent preventive treatment in areas of stable transmission. In line with this recommendation, approach to prevention of malaria in pregnancy changed since the early 2000 moving from weekly or bimonthly chemoprophylaxis adopted in the year 2005

Despite improved antenatal care services and the health education provided during these services, the prevalence of malaria in pregnancy continues to be high as portrayed by available statistics from health facilities in Calabar and Nigeria as a whole. Based on these facts, it becomes necessary to ascertain the knowledge, attitude and practice of pregnant women toward prevention and control of malaria in University of Calabar Teaching Hospital.

1.3 Objectives of the Study

The main objective of this study is to assess the knowledge, attitude and practice of pregnant women toward prevention and control of malaria in University of Calabar Teaching Hospital. Other specific objectives are to:

To determine the knowledge of pregnant women about malaria prevention and control.
To examine the attitude of pregnant women about malaria prevention and control
To identify the practice used in malaria prevention and control among pregnant mothers attending ANC at University of Calabar Teaching Hospital.

1.4 Research Questions

The research will seek to answer the following questions:

What is the knowledge of pregnant women about malaria prevention and control?
What are the attitude of pregnant women about malaria prevention and control?
What are the practice used in malaria prevention and control among pregnant women attending ANC at University of Calabar Teaching Hospital?

1.5 Research Hypotheses

Ho: Pregnant women attending ANC at University of Calabar Teaching Hospital do not have positive attitude towards malaria prevention and control practices.
Ha: Pregnant women attending ANC at University of Calabar Teaching Hospital have positive attitude towards malaria prevention and control practices.

1.6 Significance of the Study

The success of malaria control intervention requires high utilization of global and national interventions. However, inadequate knowledge is a main challenge for appropriate use of these interventions at individual and community level (David etal 2015).

In Calabar, many pregnant women still use traditional practices (like herbs) to treat and prevent malaria rather going to the hospital for modern medicine. This study therefore intends to have the following nurses’ implementations;

Nursing education:

The result from this study will be a base of knowledge through revelation of knowledge, attitude and practice of pregnant mothers, of which some finding may be integrated into nursing school curriculum. On the other hand, MOH planners and administration in particular of which the majority are the nursing, may use the information in formulating a policies aimed at controlling of malaria in pregnancy.

Nursing Practice:

The research finding should be used by nurses to influence cultural leaders, community members and political leaders in developing positive strategies to combat malaria among pregnancy

Nursing Research:

The finding from this research may serves as part of existing literature that may be used by others researcher who may have interest in a similar study. On the other hand, the recommendations from this study may serve as basis for further research.

1.7 Scope of the Study

This study focuses on the knowledge, attitude and practice of pregnant women toward prevention and control of malaria in University of Calabar Teaching Hospital. Hence, the respondents for this study will be obtained among pregnant women attending ANA in University of Calabar Teaching Hospital.

1.8 Limitations of the Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study.

Moreover, the case study method utilized in the study posed some challenges to the investigator including the possibility of biases and poor judgment of issues. However, the investigator relied on respect for the general principles of procedures, justice, fairness, objectivity in observation and recording, and weighing of evidence to overcome the challenges.

1.9 Definition of Terms

Malaria:

Malaria is caused by infection with a microscopic parasite and is transmitted to humans by the bite of certain sorts of mosquito called anophelines.

Antenatal Care:

Antenatal care is the care you get from health professionals during your pregnancy. It’s sometimes called pregnancy care or maternity care.

1.10 Organization of the Studies

The study is categorized into five chapters. The first chapter presents the background of the study, statement of the problem, objective of the study, research questions and hypothesis, the significance of the study, scope/limitations of the study, and definition of terms. The chapter two covers the review of literature with emphasis on conceptual framework, theoretical framework, and empirical review. Likewise, the chapter three which is the research methodology, specifically covers the research design, population of the study, sample size determination, sample size, and selection technique and procedure, research instrument and administration, method of data collection, method of data analysis, validity and reliability of the study, and ethical consideration. The second to last chapter being the chapter four presents the data presentation and analysis, while the last chapter(chapter five) contains the summary, conclusion and recommendation.

Chapter Five

Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings on the knowledge, attitude and practice of pregnant women toward prevention and control of malaria in University of Calabar Teaching Hospital. The chapter consists of summary of the study, conclusions, and recommendations.

5.2 Summary of the Study

In this study, our focus was to examine the knowledge, attitude and practice of pregnant women toward prevention and control of malaria in University of Calabar Teaching Hospital. The study was specifically carried out to determine the knowledge of pregnant women about malaria prevention and control, examine the attitude of pregnant women about malaria prevention and control and identify the practice used in malaria prevention and control among pregnant mothers attending ANC at University of Calabar Teaching Hospital.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 150 responses were validated from the enrolled participants where all respondent were pregnant women attending ANA in University of Calabar Teaching Hospital.

5.3 Conclusions

Based on the findings of this study, the researcher concluded that;

Pregnant women attending ANA in University of Calabar Teaching Hospital have adequate knowledge about malaria prevention and control.
Pregnant women attending ANA in University of Calabar Teaching Hospital have good attitude towards malaria prevention and control.
To prevention and control malaria, pregnant women attending ANC at University of Calabar Teaching Hospital make effective use of mosquito net, ensure indoor residual spraying, makes use of antimalarial prophylaxis, spray insecticides, and use traditional medicine.

5.4 Recommendations

Based on the findings of the study, the following recommendations are proffered.

The ministry of health should continue community support in malaria prevention like distribution of free insecticide treated mosquito nets.
The district health office and partner should put more funding of malaria control and prevention programs not only through availing effective diagnostic and treatment services but also community education on malaria prevention.
The health workers at the heath unit should ensure routine health education on malaria prevention and control. This can be done both at community level and at individual level at the health Centre.
The nursing research should carry out further research study on; Factors affecting the effectiveness of malaria preventive measures in rural communities.