Knowledge of medicine outlets' staff and their practices for prevention and management of malaria in Ghana.

Objective: To obtain information about the staff resources available in licensed medicine outlets, assess their knowledge about malaria illness, current policy initiatives for malaria control, and the practices for prevention and management of malaria.

Setting: Hospitals/clinics and retail medicine outlets (community pharmacies and licensed chemical shops) from urban and rural areas in Southern and Northern Ghana.

Method: A cross section of medicine outlets (n = 121) in the two geographic and socio-economically diverse settings in Ghana were sampled. Data on staff resources, their knowledge about malaria, and current initiatives for malaria control were obtained through structured interviews. Staff practices for prevention and management of malaria were assessed through observation of their practice during counseling, selection, and dispensing of anti-malarial.

Main Outcome Measures: Professional status of staff in the outlets, the proportion of staff with adequate knowledge on malaria illness and the initiatives for malaria control; skills and practices for the recognition, prevention, and management of malaria.

Results: 56% of the staff (n = 269) were non-professionals, whereas 44% (n = 212) were professionals. The hospitals/clinics had more professional staff per outlet than the retail outlets. One hundred and fifty four staff members, including those in-charge of the outlets at the time of data collection (n = 121), and others recommended by the in-charges or outlet owners (n = 33) were assessed. Of these, 83% knew the mode of malaria transmission, 81% could advise clients on practices for malaria prevention, 88% recognized signs/symptoms of uncomplicated malaria, and 64% those of complicated malaria. Less than 40% had adequate knowledge about current initiatives for malarial control, and only 21% could manage malaria cases as recommended by national guidelines.

Conclusion: Most of the staff, particularly those in the retail outlets were not professionally trained. The staff assessed could recognize malaria illness and counsel clients on practices for disease prevention. The majority, however, lacked knowledge on the current initiatives for malaria control and the skills to manage malaria cases appropriately. In order to achieve public health objectives, interventions to strengthen skills and improve practices for malaria case management are needed. Training on current initiatives for malaria control should also be considered a priority.