Process evaluation of uncomplicated malaria management in selected health facilities of Ahferom District, Tigray, Northern Ethiopia

Abstract

Introduction: Malaria is a major public health problem in Ethiopia. Approximately 68% of the populations live in malaria risk areas. Early diagnosis and prompt treatment is one of the main strategies in malaria prevention and control. Likewise, Ahferom district shares the problem and the stakeholders had shown their interest to conduct process evaluation.

Objective: To evaluate the implementation of malaria diagnosis and treatment in selected primary health facilities of Ahferom district in 2016.

Method: Facility based descriptive case study was conducted. Focus of the evaluation was process with formative approach. Dimensions of the evaluation were availability, compliance and accommodation.  Data were collected by reviewing a sample of 296 clinical records and were analyzed using SPSS version 20. It was supplemented through direct observation of health care providers practice. Finally, judgment was made based on the preset matrix of analysis and judgment criteria.

Result: Of the three health facilities, two (66.7%) provided malaria diagnosis and treatment services 24 hours/day and seven days/week. Although, there was no stock out of medical equipment, nearly 50% of anti-malaria drugs had exhibited stock out.Accordingly, the availability dimension was judged good (80%). Compliance of health care providers to the national guide line was judged fair (60%). Almost all (99.3%) of clients were not recorded their body weight and only (24%) were recorded their body temperature. Of the observed laboratory investigations, both thick and thin blood films were prepared for only 16.3% of patients. Accommodation was judged excellent (96%) in which almost all interviewed patients were satisfied by the services they rendered.

Conclusion and recommendation: The overall quality of the service was judged good. The absence of nearly half anti-malaria drugs and non-compliance of health care providers with the national guideline had found to be fair. Hence, anti-malaria drugs need to be imported through whole sellers and have to be purchased; and health care providers should be motivated to enhance compliance.