Primacy of effective communication and its influence on adherence to artemether-lumefantrine treatment for children under five years of age: a qualitative study Full Text
BMC Health Services Research, 06/22/2012
Simba DO et al. – There is need for a review of the national malaria treatment guidelines to address local context. In the review, emphasis should be put on on–the–job training to address practical problems faced by providers in the course of their work. Further research is needed to determine the implication of completing artemether–lumefantrine (AL) treatment prior to scheduled time.Methods
- A qualitative study was conducted in five villages in Kilosa district, Tanzania.
- In-depth interviews were held with providers that included prescribers and dispensers; and caretakers whose children had just received AL treatment.
- Information was collected on providers' instructions to caretakers regarding dose timing and how to administer AL; and caretakers' understanding of providers' instructions.
- Mismatch was found on providers' instructions as regards to dose timing.
- Some providers' (dogmatists) instructions were based on strict hourly schedule (conventional) which was likely to lead to administering some doses in awkward hours and completing treatment several hours before the scheduled time.
- Other providers (pragmatists) based their instruction on the existing circumstances (contextual) which was likely to lead to delays in administering the initial dose with serious treatment outcomes. Findings suggest that, the national treatment guidelines do not provide explicit information on how to address the various scenarios found in the field.
- A communication gap was also noted in which some important instructions on how to administer the doses were sometimes not provided or were given with false reasons.