ABSTRACT

Malaria during pregnancy remains a significant public health challenge in endemic regions, with adverse outcomes for both mothers and infants. Despite the availability of preventive measures, gaps in knowledge and practices persist among pregnant women, particularly in resource-limited settings. This study aims to assess the knowledge and practices of mothers regarding malaria prevention during pregnancy in the Mile 16 Health Area of the Buea Health District. Through a comprehensive literature review, socio-economic factors, cultural beliefs, and access to healthcare services were identified as influencing factors. The study will employ a mixed-methods approach, including surveys and qualitative interviews, to explore these factors further. Findings from this research will provide valuable insights into the barriers to the uptake of malaria prevention interventions among pregnant women in the study area. This information will inform the development of targeted interventions and policies to improve maternal and child health outcomes related to malaria in pregnancy.

Chapter One: Introduction

1.1 Background of the Study

CHAPTER ONE:
INTRODUCTION

Malaria in pregnancy poses significant risks to both maternal and fetal health, particularly in endemic regions such as sub-Saharan Africa. Despite concerted efforts to control malaria, it remains a major public health concern, with pregnant women and young children being particularly vulnerable to its effects (WHO, 2020). In areas like the Mile 16 Health Area of the Buea Health District, malaria transmission is endemic, and pregnant women are at increased risk of infection due to physiological changes that make them more susceptible to malaria parasites (Desai et al., 2007). The consequences of malaria in pregnancy include maternal anemia, low birth weight, preterm delivery, and increased infant mortality (Steketee et al., 2001).

Preventive measures such as the use of insecticide-treated bed nets (ITNs), intermittent preventive treatment during pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP), and effective case management are recommended by the World Health Organization (WHO) to reduce the burden of malaria in pregnant women (WHO, 2019). However, the effectiveness of these interventions depends on their uptake and adherence by pregnant women. Studies have shown that despite the availability of these preventive measures, there are gaps in knowledge and practices among pregnant women regarding malaria prevention (Mwandama et al., 2015).

Furthermore, socio-economic factors, cultural beliefs, and access to healthcare services influence the utilization of malaria preventive measures among pregnant women (Okonta & Oseji, 2007). In resource-limited settings like the Buea Health District, pregnant women may face barriers such as cost, distance to healthcare facilities, and availability of services, which can affect their ability to access and utilize malaria prevention interventions (Mbonye et al., 2019).

Understanding the knowledge and practices of mothers regarding malaria prevention during pregnancy is crucial for designing targeted interventions to improve maternal and child health outcomes in malaria-endemic areas. Assessing the knowledge gaps and identifying barriers to the uptake of preventive measures can inform the development of context-specific strategies to enhance malaria prevention efforts among pregnant women (Hill et al., 2018). Therefore, this study aims to assess the knowledge and practices of mothers regarding the prevention of malaria in pregnancy in the Mile 16 Health Area of the Buea Health District.

Through this research, we seek to contribute valuable insights into the factors influencing the uptake of malaria prevention interventions among pregnant women in this region. By identifying gaps in knowledge and barriers to the utilization of preventive measures, we aim to inform the development of targeted interventions and policies to improve maternal and child health outcomes related to malaria in pregnancy.

Problem Statement

Every year the government and the private sector have been training health care Professionals in health care training schools and institutions and sending them to various hospitals in various communities. This is in line to educate especially pregnant or non pregnant mothers about Malaria and practices aimed at preventing its hazardous effects in pregnancy. This is to help solve some of the problems and complications that arise with this infection in pregnancy. In the same vein, seminars are being organized for nurses, midwives, epidemiologists and so on, to share considerable knowledge, skill and expertise in educating, introducing new approaches and above all identifying the areas of endemicity and others. Malaria is a disease that’s clearly observed in every community and neighborhood.

As a nurse in the field, I have observed that, even with the existing medical equipment and knowledge, when not properly used in the community, neighborhood or in hospital, mothers face a lot of challenges combatting Malaria especially in pregnancy. The surge in cases of pregnancy with Malaria has become a problem in the community and health care team leading to a poor prognosis. In our hospitals, little is being done to curb the incidence of Malaria as greater effort is focused on treatment rather than education on practices aimed at preventing its endemicity.

Although education is an important measure in the prevention of Malaria especially in pregnancy, it is often neglected by many health professionals including nurses who believe that mothers already have the knowledge about this pathology and how to prevent it. They also believe that treatment is more important than prevention mindful of treatment by prophylaxis. Malaria in pregnancy limits the chances of a safe at term delivery in mothers and also increases maternal morbidity and mortality. In our communities, little is being done to remedy this situation.

Literature has revealed that Malaria is deadly via its severe complications especially in pregnancy. The absence of good medical equipment, good Education and knowledge deficit affects pregnant women. Failure of women to use LLITNs have exposed health care workers to difficulties when catering for these Patients or clients. As a result, our society keeps witnessing a constant presence of Malaria and the rise in cases regarding pregnancy. This endemicity of Malaria and its incidence is being attributed to knowledge deficit and other factors such as ignorance, non compliance to preventive practices, poor environmental hygiene, the influence of some cultural practices and sometimes socioeconomic factors. It’s as a result of these consequences to this problem that the researcher set in to Assess mothers’ knowledge and practices on the prevention of Malaria in pregnancy in the mile 16 health area.

Research Questions

General research question

What are mothers’ knowledge and practices on the prevention of Malaria in pregnancy in mile 16 health area of Buea Health District.

Specific research questions.

1. How knowledgeable are mothers on the prevention of Malaria in pregnancy in mile 16 health area of Buea Health District?
2. What are the various practices employed by mothers in the prevention of Malaria in pregnancy in mile 16 health area of Buea Health District?
3. What are the challenges mothers face in preventing Malaria in pregnancy in mile 16 health area of Buea Health District?

Hypothesis

Ho: Mothers have inadequate knowledge and practice on the prevention of Malaria in pregnancy.

Research objectives

General objective

To assess mothers’ knowledge and practices on the prevention of Malaria in pregnancy in mile 16 health area of Buea Health District.

Specific objectives

1. To assess mothers’ knowledge on prevention of Malaria in pregnancy in mile 16 health area of Buea Health District
2. To assess mothers’ practices on the prevention of Malaria in pregnancy in mile 16 health area of Buea Health District.
3. To find out challenges mothers face on the prevention of Malaria in pregnancy in mile 16 health area of Buea Health District.

Scope of study

This study was conducted within the mile 16 health area. The researcher was out to assess the knowledge and practices on the prevention of Malaria in pregnancy. Mothers were selected from the four villages of the mile 16 health area. Mothers selected were pregnant and non-pregnant but had at least one live birth.

Significance of the study

It is hoped that upon completion, the findings and results of this study might be of help to; pregnant and non pregnant mothers, health care authorities, youths most importantly females of child bearing age and parents.

Pregnant Mothers

The study might be of great importance to pregnant women because it might help them gain an insight and also know the practices and preventive measures and how to effectively utilize them so as to prevent and protect subsequent pregnancies from complications of Malaria. This will also improve the quality of health both for the mother and the growing fetus. For example, draining stagnant water around the communities and clearing standing bushes that constantly serve as breeding ground for mosquitoes. This will help eradicate mosquitoes and hence, limit Malaria spread and therefore reduce the cost of treatment.

Non pregnant women

This study might be of great importance to non pregnant women because it might help them gain knowledge and understanding on safe practices to prevent Malaria in pregnancy and its complications. For example, practices like the use of long lasting insecticide treated mosquito nets.

Health care authorities

This study might be of great importance to the health care authorities because it might help them derive new strategies and even improve on old practices. It might also help them improve on educational activities so as to curb the spread of Malaria and hence prevent it in pregnant women and mothers at large. For example, organizing community out reaching programs and educating mothers on how to cater for and effectively use available resources for prevention. examples, long lasting insecticide treated mosquito nets, insect sprays and so on.

Definition of terms

Mother:

A mother is a female parent of a child. Mothers are women who inhabit or perform the role of bearing some relation to their children, who may or may not be their biological offspring. Contextually, women can be considered mothers by virtue of having given birth, by raising their children, supply their ovum for fertilization (“definition of mother from Oxford dictionary online).

The process of becoming a mother has been referred to as “matrescence”. (Sacks et al 2017;”the birth of a mother”).

According to this study, a mother is a female who is married in to a family with children and having that responsibility of looking after the children.

Knowledge:

Knowledge refers to a theoretical or practical understanding of a subject. It can implicit (as with practical skill or expertise) or explicit (as with theoretical understanding of a subject; formal or informal, systematic or particular). (“knowledge; definition of knowledge in Oxford dictionary 2010). In this study, knowledge relates to mothers’ general knowledge on malaria and ways to treat and prevent it in pregnancy.

Practice:

According to Oxford advance learner’s dictionary (2010), practice is a habit or custom that’s Carried out regularly. This study focused on mother’s knowledge and what mothers do to prevent Malaria in pregnancy.