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

degree and very few of them had postgraduate degree. were statistically significantly more knowledgeable on the
This could explain why majority of them do not have good implementation of the NMCP (P < 0.001).
knowledge of case definition of simple and complicated
malaria. Respondents with diploma/certificate were Furthermore, less than half of the respondents would give
statistically significant more frequent than respondents LLINs to all patients treated for malaria. This is not in the
with bachelor degree and postgraduate degree (P = 0.016). guidelines for the prevention of malaria and will result in
stock out (a situation in which the demand or requirement
Majority of the health‑care workers in the PHCs were for an item cannot be fulfilled from the current inventory) of
Community Health Officers/Community Health Extension LLINs in these LGAs. The gap in between the knowledge and
Workers (CHOs/CHEWs), followed by the nurses, other health implementation may be due to the fact that health workers
workers and very few were doctors, this finding is different at the implementation level were not the health workers at
[13]
from a similar study in Ibadan. The CHEWs were statistically the training. This was statistically significant (P = 0.006).
significantly more than other health workers (P = 0.019). Less than half of the respondents used clinical suspicion to
The community health extension workers stay more in the make diagnosis. This was statistically significant (P = 0.032).
community and do more of on the job learning, this could This finding is consistent with report on malaria treatment
explain why more of the respondents had good knowledge in Ogun State where it was revealed that cases treated were
of signs and symptoms of simple malaria. far higher than those who got tested. [18]
A significantly higher proportion of health workers
Larger percentages of the respondents use ACT to treat
with ≥15 years’ work experience at the PHC had good
malaria; this shows that use of ACT in treatment of
score of the knowledge of the NMCP (P = 0.006). More
uncomplicated malaria is widely accepted by most health
than two‑third of the respondents already had training on
workers. This is in keeping with the Nigeria’s NMCP
NMCP, this is different from finding from similar studies
target of at least 80% of fever/malaria patients receive
within and outside Nigeria. [14‑16] Majority of respondents
appropriate and timely treatment according to national
in Ewekoro already had training on NMCP while only
treatment guidelines. [19] The findings were similar to
two‑third in Ijebu‑ode and 62.4% in Ado‑odo/Ota had
another study in Uganda [20] but differ from the result of
training on NMCP, this is different from finding from similar
finding in another study in Tanzania where only few of
study in Jos, Nigeria. [16]
the health workers prescribed ACT for the treatment of
uncomplicated malaria. [21]
Higher proportion of the respondents knew the goals
of the NMCP, almost all the respondents identified that Limitation of the study
NMCP intervention comprises of both prevention and case
The study was conducted toward the end of the year when
management, these findings is higher than result from
some of the health‑care workers were on leave. This led to
similar study in India where only few of the respondents
an extension of the study till May 2014. Some of the health
were aware and had knowledge of the drug policy. [14] More
facilities were inadequately staffed, the health workers were
than two‑third of the respondents perceived that NMCP had
on (MAN– morning, afternoon, and night) and some were
reduced the prevalence of malaria and had benefited member
on one week off and one week on. It was very difficult to
of the community. In addition, most of the respondents in
see the health workers, especially those in the rural areas.
each of the LGA knew the goals of NMCP. Large percentage
of respondents in each of the three LGA perceived that the
NMCP had reduced the prevalence of malaria in their PHCs. CONCLUSION
Majority of the respondents in each of the LGA disagreed
Knowledge of health‑care workers regarding mode of
that NMCP is not health worker friendly and does not have
transmission of malaria was good but their knowledge
any benefit to the member of the community.
about case definitions of simple and complicated malaria
A large proportion of the respondents implemented IPT was inadequate. The inability of health‑care workers
and LLINs. Majority of the respondents in each of the to correctly recognize and differentiate simple and
LGA used intermittent prevention treatment and long severe malaria could influence patient management and
lasting insecticide nets (LLINs) as malaria prevention prognosis. Therefore, there should be more supervisory
intervention. Most of the respondents gave IPT to pregnant visit to the health facilities, especially in the remote areas
women during ANC. The knowledge and use of IPT to by the health workers at the malaria control unit Ogun
prevent malaria in pregnancy by the respondents in this state Ministry of Health and Federal Ministry of Health and
study was better when compared with poor knowledge more of the younger health workers who actually manage
documented by a study from Southwest LGA of Nigeria [17] the patients should be sent for training.
and another study from Ibadan. [13] This fair assessment
may be due to several training undertaken by the health Financial support and sponsorship
workers. Respondents who gave IPT to pregnant women Nil.

JOURNAL OF CLINICAL SCIENCES, VOLUME 15, ISSUE 1, January-March 2018 Page | 53