Why don't health workers prescribe ACT A qualitative study of factors affecting the prescription of artemether-lumefantrineReportar como inadecuado




Why don't health workers prescribe ACT A qualitative study of factors affecting the prescription of artemether-lumefantrine - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Reference: Beatrice Wasunna, Dejan Zurovac, Catherine A. Goodman et al., (2008). Why don't health workers prescribe ACT? A qualitative study of factors affecting the prescription of artemether-lumefantrine. Malaria Journal, 7, Article: 29.Citable link to this page:

 

Why don't health workers prescribe ACT? A qualitative study of factors affecting the prescription of artemether-lumefantrine

Abstract: Background: Kenya recently changed its antimalarial drug policy to a specific artemisinin-based combination therapy (ACT), artemether-lumefantrine (AL). New national guidelines on the diagnosis, treatment and prevention were developed and disseminated to health workers together with in-service training.Methods: Between January and March 2007, 36 in-depth interviews were conducted in five rural districts with health workers who attended in-service training and were non-adherent to the new guidelines. A further 20 interviews were undertaken with training facilitators and members of District Health Management Teams (DHMTs) to explore reasons underlying health workers' non-adherence.Results: Health workers generally perceived AL as being tolerable and efficacious as compared to amodiaquine and sulphadoxine-pyremethamine. However, a number of key reasons for non-adherence were identified. Insufficient supply of AL was a major issue and hence fears of stock outs and concern about AL costs was an impediment to AL prescription. Training messages that contradicted the recommended guidelines also led to health worker non-adherence, compounded by a lack of follow-up supervision. In addition, the availability of non-recommended antimalarials such as amodiaquine caused prescription confusion. Some health workers and DHMT members maintained that shortage of staff had resulted in increased patient caseload affecting the delivery of the desirable quality of care and adherence to guidelines.Conclusions: The introduction of free eficacious ACTs in the public health sector in Kenya and other countries has major potential public health benefits for Africa. These may not be realized if provider prescription practices do not conform to the recommended treatment guidelines. It is essential that high quality training, drug supply and supervision work synergistically to ensure approapriate case management.

Publication status:PublishedPeer Review status:Peer reviewedVersion:Publisher's versionNotes:Citation: Wasunna, B. et al. (2008). 'Why don't health workers prescribe ACT? A qualitative study of factors affecting the prescription of artemether-lumefantrine', Malaria Journal, 7;29. [This article is available from: http://www.malariajournal.com/content/7/1/29]. Copyright 2008 Wasunna et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Bibliographic Details

Publisher: BioMed Central Ltd.

Publisher Website: http://www.biomedcentral.com

Host: Malaria Journalsee more from them

Publication Website: http://www.malariajournal.com

Issue Date: 2008-February

Copyright Date: 2008

pages:Article: 29Identifiers

Doi: https://doi.org/10.1186/1475-2875-7-29

Issn: 1475-2875

Urn: uuid:9dccc067-d4b1-45ad-9207-d4e628b49243 Item Description

Type: Article: post-print;

Language: en

Version: Publisher's versionKeywords: artemether-lumenfantrine Kenya malaria treatment guidelinesSubjects: Malaria Infectious diseases Tropical medicine Tiny URL: ora:2423

Relationships





Autor: Beatrice Wasunna - institutionEastern and Southern Africa Centre of International Parasite Control ESACIPAC- KEMRI, Nairobi, Keny

Fuente: https://ora.ox.ac.uk/objects/uuid:9dccc067-d4b1-45ad-9207-d4e628b49243



DESCARGAR PDF




Documentos relacionados