Health workers’ adherence to malaria case management protocols in Northern Sudan: a qualitative study
Abstract Background Nonadherence to national standards for malaria diagnosis and treatment has been reported in Sudan. In this study, qualitative research examined the clinical domains of nonadherence, factors influencing nonadherent practices and health workers’ views on how to improve adherence. M...
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ftdoajarticles:oai:doaj.org/article:279421997feb46598178ad63e41dc834 2024-09-09T19:27:29+00:00 Health workers’ adherence to malaria case management protocols in Northern Sudan: a qualitative study Sahar Khalid Mohamed Duha Khalid Mohamed Khansaa Ahmed Fadwa Saad Dejan Zurovac 2024-05-01T00:00:00Z https://doi.org/10.1186/s12936-024-04998-9 https://doaj.org/article/279421997feb46598178ad63e41dc834 EN eng BMC https://doi.org/10.1186/s12936-024-04998-9 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-024-04998-9 1475-2875 https://doaj.org/article/279421997feb46598178ad63e41dc834 Malaria Journal, Vol 23, Iss 1, Pp 1-14 (2024) Malaria Adherence Healthcare providers Quality of care Sudan Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2024 ftdoajarticles https://doi.org/10.1186/s12936-024-04998-9 2024-08-05T17:49:17Z Abstract Background Nonadherence to national standards for malaria diagnosis and treatment has been reported in Sudan. In this study, qualitative research examined the clinical domains of nonadherence, factors influencing nonadherent practices and health workers’ views on how to improve adherence. Methods In September 2023, five Focus Group Discussions (FGDs) were undertaken with 104 health workers from 42 health facilities in Sudan’s Northern State. The participants included medical assistants, doctors, nurses, laboratory personnel, pharmacists and public health officers. The FGDs followed a semi-structured guide reflecting the national malaria case management protocol. Qualitative thematic analysis was performed. Results Nonadherent practices included disregarding parasitological test results, suboptimal paediatric artemether–lumefantrine (AL) dosing, lack of counselling, use of prohibited artemether injections for uncomplicated and severe malaria, artesunate dose approximations and suboptimal preparations, lack of AL follow on treatment for severe malaria; and rare use of primaquine for radical Plasmodium vivax treatment and dihydroartemisinin-piperaquine as the second-line treatment for uncomplicated malaria. Factors influencing nonadherence included stock-outs of anti-malarials and RDTs; staff shortages; lack of training, job aids and supervision; malpractice by specialists; distrust of malaria microscopy and RDTs; and patient pressure for diagnosis and treatment. Health workers recommended strengthening the supply chain; hiring personnel; providing in-service protocol training including specialists; establishing external quality assurance for malaria diagnosis; and providing onsite supportive supervision and public health campaigns. Conclusions This study revealed a broad spectrum of behavioural and systemic challenges in malaria management among frontline health workers in Northern Sudan, including nonadherence to protocols due to resource shortages, training gaps, a lack of supportive supervision and ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 23 1 |
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Malaria Adherence Healthcare providers Quality of care Sudan Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Malaria Adherence Healthcare providers Quality of care Sudan Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Sahar Khalid Mohamed Duha Khalid Mohamed Khansaa Ahmed Fadwa Saad Dejan Zurovac Health workers’ adherence to malaria case management protocols in Northern Sudan: a qualitative study |
topic_facet |
Malaria Adherence Healthcare providers Quality of care Sudan Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Nonadherence to national standards for malaria diagnosis and treatment has been reported in Sudan. In this study, qualitative research examined the clinical domains of nonadherence, factors influencing nonadherent practices and health workers’ views on how to improve adherence. Methods In September 2023, five Focus Group Discussions (FGDs) were undertaken with 104 health workers from 42 health facilities in Sudan’s Northern State. The participants included medical assistants, doctors, nurses, laboratory personnel, pharmacists and public health officers. The FGDs followed a semi-structured guide reflecting the national malaria case management protocol. Qualitative thematic analysis was performed. Results Nonadherent practices included disregarding parasitological test results, suboptimal paediatric artemether–lumefantrine (AL) dosing, lack of counselling, use of prohibited artemether injections for uncomplicated and severe malaria, artesunate dose approximations and suboptimal preparations, lack of AL follow on treatment for severe malaria; and rare use of primaquine for radical Plasmodium vivax treatment and dihydroartemisinin-piperaquine as the second-line treatment for uncomplicated malaria. Factors influencing nonadherence included stock-outs of anti-malarials and RDTs; staff shortages; lack of training, job aids and supervision; malpractice by specialists; distrust of malaria microscopy and RDTs; and patient pressure for diagnosis and treatment. Health workers recommended strengthening the supply chain; hiring personnel; providing in-service protocol training including specialists; establishing external quality assurance for malaria diagnosis; and providing onsite supportive supervision and public health campaigns. Conclusions This study revealed a broad spectrum of behavioural and systemic challenges in malaria management among frontline health workers in Northern Sudan, including nonadherence to protocols due to resource shortages, training gaps, a lack of supportive supervision and ... |
format |
Article in Journal/Newspaper |
author |
Sahar Khalid Mohamed Duha Khalid Mohamed Khansaa Ahmed Fadwa Saad Dejan Zurovac |
author_facet |
Sahar Khalid Mohamed Duha Khalid Mohamed Khansaa Ahmed Fadwa Saad Dejan Zurovac |
author_sort |
Sahar Khalid Mohamed |
title |
Health workers’ adherence to malaria case management protocols in Northern Sudan: a qualitative study |
title_short |
Health workers’ adherence to malaria case management protocols in Northern Sudan: a qualitative study |
title_full |
Health workers’ adherence to malaria case management protocols in Northern Sudan: a qualitative study |
title_fullStr |
Health workers’ adherence to malaria case management protocols in Northern Sudan: a qualitative study |
title_full_unstemmed |
Health workers’ adherence to malaria case management protocols in Northern Sudan: a qualitative study |
title_sort |
health workers’ adherence to malaria case management protocols in northern sudan: a qualitative study |
publisher |
BMC |
publishDate |
2024 |
url |
https://doi.org/10.1186/s12936-024-04998-9 https://doaj.org/article/279421997feb46598178ad63e41dc834 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 23, Iss 1, Pp 1-14 (2024) |
op_relation |
https://doi.org/10.1186/s12936-024-04998-9 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-024-04998-9 1475-2875 https://doaj.org/article/279421997feb46598178ad63e41dc834 |
op_doi |
https://doi.org/10.1186/s12936-024-04998-9 |
container_title |
Malaria Journal |
container_volume |
23 |
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1 |
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1809896920584290304 |