Knowledge and practice on malaria diagnosis and treatment among private health care providers in Ethiopia

As many as 60–80% of people in developing countries first seek malaria treatment at private than public health facilities, but the technical quality of private services is questionable. Before commencing Public Private Partnership for malaria, we want to assess the knowledge and practice on malaria diagnosis and treatment among health care providers (HCPs) working in Private Health Facilities (PHFs) in Ethiopia.

We conducted facility based cross-sectional study from April to June 2012. Quantitative and qualitative data was collected, entered and analyzed using SPSS version 20.  We enrolled 264 HCPs from 264 PHF in malaria endemic towns.

The majority of the HCP were male (84.5%), 106(40%) were nurses and 135(51.0%) have practiced more than seven years. The knowledge of HCPs on malaria program was computed out of five and the mean score was s 2.52 (95% CI: 2.32 - 2.72) with 40.5% of them scoring above the mean. The majority know the recommended treatment for confirmed diagnosis (91.3% for P. vivax & 88.6% for P. falciparum). Nearly 92.4% suspected cases were investigated for parasitological diagnosis. The malaria slide positivity rate was 37.6%, however, only 60.6% of the confirmed cases were treated for malaria. Presumptive malaria treatment was offered to about 40% of patients.  The adherence rate of HCPs on prescribing the recommended first line drugs was 44.2% for Chloroquine, 47.9% for ACT and 77.9% for Quinine. The study revealed HCP in private practice have major gaps in knowledge and practice related to malaria case management in Ethiopia. Therefore, provision of malaria diagnosis and case management training, supportive supervision and job aids is recommended.