The Effect of Malaria Integrated Supportive Supervision (Miss) on Knowledge and Practice of Malaria Prevention and Management: A Comparative Study of Miss Supported and Non Supported Primary Health Facilities in Nasarawa State, Nigeria

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DOI: 10.21522/TIJPH.2013.05.04.Art008

Authors : Alabi Babatunde


Background: Malaria is a major cause of morbidity and mortality in Nigeria, directly contributing to poverty, low productivity, and reduced school attendance. The mosquito-borne illness causes over 100 million clinical cases every year. It accounts for about 60% of all outpatient attendances and 30% of all hospital admissions and is responsible for the annual death of 300,000 children under 5 years as well as 11% of maternal mortality cases reported each year. In children, malaria is responsible for 25% of all infant-related mortality and 30% of child-related mortality. (National Malaria Control Strategic Plan FMOH 2009-2013)

 Integrated Supportive Supervision (ISS) is a harmonized supervisory system which uses a common tool and reporting format based on a collection of indicators from as many work processes/initiatives/programmes as possible. It is driven by a common supervisory team usually working as several sub-teams, thus ensuring that managers are in the field on a regular basis (monthly or quarterly) to check the performance of subordinates and help them to improve on their competencies and output. What is also key besides getting managers into the field on a regular basis and thus understanding the context and challenges within which health workers function, is the importance of both supervisors and supervisees agreeing on a plan of action to improve health care delivery. This plan of action must include activities/actions by both the supervisor and the supervisee. This is critically important and can be used to measure progress on subsequent visits.

This study aimed at evaluating the effect Malaria Integrated Supportive Supervision (MISS) on Malaria Service Delivery in MISS supported Primary Health Facilities and Non-Supported Primary Health Facilities across various LGAs in Nasarawa State.

Materials and Methods: This was a facility-based interventional study with MISS intervention and MISS non- intervention groups. The study subjects were Officers in charge of each Primary Health Facility, selected through a multistage sampling technique and data collection was done using semi structured self-administered questionnaire, all data were entered in an Excel sheet and analyzed using SPSS version 17.0. Paired t test was used in testing for significance between intervention and non-intervention group.

Results: On the Knowledge and Practice of malaria prevention and vector control, the mean score for the MISS and Non MISS groups are; 92.98 and 53.41respectively. The two-tailed P value equals 0.0395 which by conventional criteria, this difference is considered to be statistically significant.

Mean score on Diagnosis and Treatment knowledge and practice between the MISS intervention and Non-MISS intervention groups are; 81.49 and 66.53 respectively. The two-tailed P value equals 0.0642. By conventional criteria, this difference is considered not to be quite statistically significant. This could however be attributed partly to the fact that trainings on diagnosis and treatment was held jointly among the two groups.

Malaria in Pregnancy mean score between the MISS intervention and Non-MISS Intervention groups was 86.38 and 66.10 respectively. The two-tailed P value equals 0.0138 which by conventional criteria, this difference is considered to be statistically significant.

Conclusion: This study has demonstrated that integrated supportive supervision is an effective tool of improving knowledge and practice of malaria prevention and case management in Primary Health Facilities.


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