Perceptions and drivers of healthcare provider and drug dispenser practices for the treatment of malaria in pregnancy in the context of multiple first-line therapies in western Kenya: a qualitative study
Abstract Background Emergence of Plasmodium falciparum resistance to artemether-lumefantrine in Africa prompted the pilot introduction of multiple first-line therapies (MFT) against malaria in Kenya, potentially exposing women-of-childbearing-age (WOCBAs) to anti-malarials with unknown safety profil...
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ftdoajarticles:oai:doaj.org/article:59ab1431cea84ff4a9a8f91072f5e7c7 2023-10-09T21:49:34+02:00 Perceptions and drivers of healthcare provider and drug dispenser practices for the treatment of malaria in pregnancy in the context of multiple first-line therapies in western Kenya: a qualitative study Caroline B. Osoro Stephanie Dellicour Eleanor Ochodo Taryn Young Feiko O. ter Kuile Julie R. Gutman Jenny Hill 2023-09-01T00:00:00Z https://doi.org/10.1186/s12936-023-04698-w https://doaj.org/article/59ab1431cea84ff4a9a8f91072f5e7c7 EN eng BMC https://doi.org/10.1186/s12936-023-04698-w https://doaj.org/toc/1475-2875 doi:10.1186/s12936-023-04698-w 1475-2875 https://doaj.org/article/59ab1431cea84ff4a9a8f91072f5e7c7 Malaria Journal, Vol 22, Iss 1, Pp 1-12 (2023) Anti-malarials Artemisinin-based combination therapies Malaria Pregnancy Healthcare providers Knowledge Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2023 ftdoajarticles https://doi.org/10.1186/s12936-023-04698-w 2023-09-24T00:42:55Z Abstract Background Emergence of Plasmodium falciparum resistance to artemether-lumefantrine in Africa prompted the pilot introduction of multiple first-line therapies (MFT) against malaria in Kenya, potentially exposing women-of-childbearing-age (WOCBAs) to anti-malarials with unknown safety profiles in the first trimester. This qualitative study explored knowledge and perceptions among healthcare providers providing malaria treatment to WOCBAs and pregnant women. Methods In-depth interviews were conducted with purposively selected public and private health facility (HF) and drug outlet (DO) providers within and outside the pilot-MFT area. County health managers were interviewed about their knowledge of the national treatment guidelines. Transcripts were coded by content analysis using the World Health Organization health system building blocks (leadership/governance, financing, health workforce, health information systems, access to medicines, and service delivery). Results Thirty providers (HF:21, DO:9) and three health managers were interviewed. Eighteen providers were from HFs in the pilot-MFT area; the remaining three and all nine DOs were outside the pilot-MFT area. The analysis revealed that providers had not been trained in malaria case management in the previous twelve months. DO providers were unfamiliar with national treatment guidelines in pregnancy and reported having no pregnancy tests. Health managers were unable to supervise DOs due to resource limitations. Providers from HFs and DOs noted poor sensitivity of malaria rapid diagnostic tests (RDTs) and hesitancy among patients who associated malaria-RDTs with HIV testing. Almost all providers reported anti-malarial stock-outs, with quinine most affected. Patient preference was a major factor in prescribing anti-malarials. Providers in HFs and DOs reported preferentially using artemether-lumefantrine in the first trimester due to the side effects and unavailability of quinine. Conclusion Knowledge of malaria case management in drug outlets and ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 22 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Anti-malarials Artemisinin-based combination therapies Malaria Pregnancy Healthcare providers Knowledge Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Anti-malarials Artemisinin-based combination therapies Malaria Pregnancy Healthcare providers Knowledge Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Caroline B. Osoro Stephanie Dellicour Eleanor Ochodo Taryn Young Feiko O. ter Kuile Julie R. Gutman Jenny Hill Perceptions and drivers of healthcare provider and drug dispenser practices for the treatment of malaria in pregnancy in the context of multiple first-line therapies in western Kenya: a qualitative study |
topic_facet |
Anti-malarials Artemisinin-based combination therapies Malaria Pregnancy Healthcare providers Knowledge Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Emergence of Plasmodium falciparum resistance to artemether-lumefantrine in Africa prompted the pilot introduction of multiple first-line therapies (MFT) against malaria in Kenya, potentially exposing women-of-childbearing-age (WOCBAs) to anti-malarials with unknown safety profiles in the first trimester. This qualitative study explored knowledge and perceptions among healthcare providers providing malaria treatment to WOCBAs and pregnant women. Methods In-depth interviews were conducted with purposively selected public and private health facility (HF) and drug outlet (DO) providers within and outside the pilot-MFT area. County health managers were interviewed about their knowledge of the national treatment guidelines. Transcripts were coded by content analysis using the World Health Organization health system building blocks (leadership/governance, financing, health workforce, health information systems, access to medicines, and service delivery). Results Thirty providers (HF:21, DO:9) and three health managers were interviewed. Eighteen providers were from HFs in the pilot-MFT area; the remaining three and all nine DOs were outside the pilot-MFT area. The analysis revealed that providers had not been trained in malaria case management in the previous twelve months. DO providers were unfamiliar with national treatment guidelines in pregnancy and reported having no pregnancy tests. Health managers were unable to supervise DOs due to resource limitations. Providers from HFs and DOs noted poor sensitivity of malaria rapid diagnostic tests (RDTs) and hesitancy among patients who associated malaria-RDTs with HIV testing. Almost all providers reported anti-malarial stock-outs, with quinine most affected. Patient preference was a major factor in prescribing anti-malarials. Providers in HFs and DOs reported preferentially using artemether-lumefantrine in the first trimester due to the side effects and unavailability of quinine. Conclusion Knowledge of malaria case management in drug outlets and ... |
format |
Article in Journal/Newspaper |
author |
Caroline B. Osoro Stephanie Dellicour Eleanor Ochodo Taryn Young Feiko O. ter Kuile Julie R. Gutman Jenny Hill |
author_facet |
Caroline B. Osoro Stephanie Dellicour Eleanor Ochodo Taryn Young Feiko O. ter Kuile Julie R. Gutman Jenny Hill |
author_sort |
Caroline B. Osoro |
title |
Perceptions and drivers of healthcare provider and drug dispenser practices for the treatment of malaria in pregnancy in the context of multiple first-line therapies in western Kenya: a qualitative study |
title_short |
Perceptions and drivers of healthcare provider and drug dispenser practices for the treatment of malaria in pregnancy in the context of multiple first-line therapies in western Kenya: a qualitative study |
title_full |
Perceptions and drivers of healthcare provider and drug dispenser practices for the treatment of malaria in pregnancy in the context of multiple first-line therapies in western Kenya: a qualitative study |
title_fullStr |
Perceptions and drivers of healthcare provider and drug dispenser practices for the treatment of malaria in pregnancy in the context of multiple first-line therapies in western Kenya: a qualitative study |
title_full_unstemmed |
Perceptions and drivers of healthcare provider and drug dispenser practices for the treatment of malaria in pregnancy in the context of multiple first-line therapies in western Kenya: a qualitative study |
title_sort |
perceptions and drivers of healthcare provider and drug dispenser practices for the treatment of malaria in pregnancy in the context of multiple first-line therapies in western kenya: a qualitative study |
publisher |
BMC |
publishDate |
2023 |
url |
https://doi.org/10.1186/s12936-023-04698-w https://doaj.org/article/59ab1431cea84ff4a9a8f91072f5e7c7 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 22, Iss 1, Pp 1-12 (2023) |
op_relation |
https://doi.org/10.1186/s12936-023-04698-w https://doaj.org/toc/1475-2875 doi:10.1186/s12936-023-04698-w 1475-2875 https://doaj.org/article/59ab1431cea84ff4a9a8f91072f5e7c7 |
op_doi |
https://doi.org/10.1186/s12936-023-04698-w |
container_title |
Malaria Journal |
container_volume |
22 |
container_issue |
1 |
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1779312594800082944 |