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Ladi-Akinyemi, et al.: Knowledge and implementation of NMCP

economic effects in Nigeria are large, with an estimated cross‑sectional study assessing the knowledge and
[3]
132 billion naira (US$ 835 million) lost annually due implementation of the NMCP among health‑care workers
to prevention and treatment costs, absenteeism, loss of in the primary health‑care centers in the state. The study
productivity, and disability. Nigeria also has one of the was between June 2013 and May 2014. The estimated
world’s highest rates of all‑cause mortality for children sample size was 300 using the formula for cross‑sectional
under five: Approximately one in six children die before study. The respondents were recruited using the cluster
[3]
their fifth birthday. In Ogun State, malaria accounts for sampling methods.
over 80% of outpatient attendance and is the most common
[4]
cause of death at the primary health‑care facilities. The Inclusion criteria
most vulnerable groups are under‑fives, pregnant women, Health‑care workers who had been working in each of the
visitors from nonendemic areas, those with sickle cell selected LGAs for at least 6 months were included in this
anemia, HIV/AIDS. [4] study.
Exclusion criteria
Malaria control can be defined as reducing malaria morbidity
and mortality to a locally acceptable level through deliberate Health‑care workers on leave and those who do not manage
efforts using the currently available preventive and curative patients were excluded from the study.
[5]
tools. Malaria control relies on effective prevention and
case management. Oftentimes substandard treatments Data collection methods
are given by untrained health workers and sometimes A pretested self‑administered questionnaire was used to
by trained health personnel who refused to update their collect necessary information by the research assistants.
[6]
knowledge. Malaria situation in Nigeria is deteriorating The questionnaire was drafted from module 2 of the case
despite numerous interventions that had been instituted management of malaria at the primary health‑care centers,
so far. An evaluation of the malaria prevention strategies Trainee content. Federal Ministry of Health, NMCP, Abuja,
using drugs among Nigerian obstetricians revealed that Nigeria. All health‑care workers in all the PHCs in each of
the majority were deficient in the current evidence‑based the selected LGA were part of the study.
[7]
recommendation. The most frequently prescribed Primary outcome
anti‑malaria drugs in the primary health centers (PHC) are
primary outcome measured was the knowledge and
chloroquine, sulfadoxine‑pyrimethamine, and artesunate
[4]
only, and some of the diagnosis is based on clinical implementation of the NMCP by the health‑care workers
assessment and not from laboratory investigations. [4] in PHC.
Data analysis
PHC is the first tier of health services in Nigeria providing
an essential health care. It is the level of health care that Information obtained from the questionnaire was entered
has full community participation and constitutes the into SPSS (IBM Corp. Released 2011. IBM SPSS Statistics
[5]
first element of a continuing health‑care process. The for Windows, Version 20.0. Armonk, NY: IBM Corp) for
community health‑care givers have access at all times to analysis and statistical calculation. Data were summarized
the PHC and are expected to refer all cases of illness that using means, standard deviation, and proportions. The data
do not respond to home management and all cases that were presented using tables and compared between the
[5]
present with danger signs or other referral signs. Thus, three LGAs. Relationships between categorical variables
the National Malaria Control Programme (NMCP) at local were tested using the Chi‑square test (likelihood ratio
government areas (LGA) level should be well implemented. were reported instead of person Chi‑square if any of the
Following the implementation of the national guidelines cell have expected count cell less than five) while ANOVA
and strategies for Malaria Prevention and Control; there was used for comparison between means. The level of
has been inadequate documentation on the progress significance was set at 95% confidence interval with
made so far. Most studies in the literature assessed the P = 0.05. Each respondent’s level of knowledge on malaria
[8]
implementation of NMCP among pregnant women, infection (parasite responsible for transmission, mode
[9]
among children <5 years old and among other members of transmission, and signs and symptoms of simple and
of the community [10] with relatively few among the health complicated malaria) and NMCP were determined with a
workers. The study serves as a feedback on the assessment scoring system. Questions on perception and practice of
of implementation of NMCP by health workers in Ogun the NMCP by the health‑care workers were also scored.
State because such assessment tools does not exist Each correct answer given one point and wrong answers
no point. Those who scored <40% were classified as having
METHODS poor knowledge, those who scored between 40%–60%
were classified as having fair knowledge and those with
This study was conducted in Ado‑odo/Ota, Ewekoro and scores greater than 60% were classified as having good
Ijebu‑ode LGA in Ogun state, Nigeria. It was a descriptive knowledge.

JOURNAL OF CLINICAL SCIENCES, VOLUME 15, ISSUE 1, January-March 2018 Page | 49