Measuring competence among Health Workers in case management of malaria in pregnancy in Rural Zambia(Gwembe)

Abstract

Introduction:Malaria is one of the leading causes of morbidity and mortality in Zambia. It is believed that malaria is responsible for up to approximately 47% of the overall disease burden for pregnant women. In Zambia it is accountable for 20% of maternal mortality. The effects of malaria in pregnancy are many; for the mother, the most common effect is maternal anemia, which reduces her ability to cope with bleeding, leading to hemorrhage during childbirth. Malaria is both preventable and treatable, but it is a complicated disease whose prevention and control requires multiple interventions. If the prevention methods like sleeping under insecticide-treated nets, and indoor residual spraying fail then treatment is imperative. Treatment begins with recognizing the symptoms of malaria, and giving the correct medication. Competency is the simultaneous integration of knowledge, skills, and attitudes required for performance in a designated role and setting. Having competent health workers is one of the ways disease burdens can be alleviated, as this can be used to discover what gaps exists and trainings can be conducted to fill such gaps. Method:It was a descriptive study done in Gwembe district, southern province, Zambia. All health workers that are in contact with pregnant women were given self-assessment questionnaire and scored according to standard competency of management of malaria in pregnancy. The standards were obtained from text books and experts in the field e.g. medical officers, national malaria center, etc. A baseline of 75% was assumed.Results:This study showed that the medical practitioner scored an average of 86%, nurses and the mid-wives both scored above the base-line with an average score of 78% and 76% respectively. The others scored 63%. Nurses and mid-wives lacked competency in some of the core competency in management of malaria in pregnancy as they scored low marks. Lowess test showed that competency score was related to age and years in service Kolmogorov-Smirnov test showed that only age had a statistically significant relationship with competency score as it had a p-value of 0.04. Conclusion:The majority of the health workers had the competency in management of malaria in pregnancy with only a few who scored below the base line and had no knowledge of some essential competency. Training is needed to effectively improve the maternal health status and in turn help reduce maternal mortality rate in the district and the whole country at large, as all the health workers will be competent.