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
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.
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.
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.
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
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.
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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