Assessing healthcare providers’ knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania
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Date
2014
Authors
Journal Title
Journal ISSN
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Publisher
Malaria journal
Abstract
Background: Research evidence is not always being disseminated to healthcare providers who need it to inform
their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the
implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is
a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and
disappointing utilization of insecticide-treated nets (ITNs).
Methods: This study compares what is known about ITNs to the related knowledge and practices of healthcare
providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated
and administered to 497 healthcare providers in Ghana (140), Laos (136), Senegal (100) and Tanzania (121). Ten
questions tested participants’ knowledge and clinical practice related to malaria prevention. Additional questions
addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions
with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics.
Results: The survey achieved a 75% response rate (372/497) across Ghana (107/140), Laos (136/136), Senegal (51/
100) and Tanzania (78/121). Few participating healthcare providers correctly answered all five knowledge questions
about ITNs (13%) or self-reported performing all five clinical practices according to established evidence (2%).
Statistically significant factors associated with higher knowledge within each country included: 1) training in
acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73); and 2) ability to read and
write English well or very well (OR 1.69, 95% CI 1.05-2.70). Statistically significant factors associated with better
clinical practices within each country include: 1) reading scientific journals from their own country (OR 1.67, 95% CI
1.10-2.54); 2) working with researchers to improve their clinical practice or quality of working life (OR 1.44, 95% CI
1.04-1.98); 3) training on malaria prevention since their last degree (OR 1.68, 95% CI 1.17-2.39); and 4) easy access
to the internet (OR 1.52, 95% CI 1.08-2.14).
Conclusions: Improving healthcare providers’ knowledge and practices is an untapped opportunity for expanding
ITN utilization and preventing malaria. This study points to several strategies that may help bridge the gap
between what is known from research evidence and the knowledge and practices of healthcare providers. Training
on acquiring systematic reviews and facilitating internet access may be particularly helpful.
Description
Keywords
Tanzania, Healthcare providers, Insecticide-treated nets
Citation
Hoffman, S.J., Guindon, G.E., Lavis, J.N., Ndossi, G.D., Osei, E.J., Sidibe, M.F. and Boupha, B., 2011. Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania. Malaria journal, 10(1), p.363.