THE AWARENESS OF MALARIA IN PREGNANT WOMEN (CASE STUDY OF YOLA NORTH L.G.A OF ADAMAWA)
1.1 BACKGROUND OF STUDY
Malaria in pregnancy is a multidimensional public health problem that has severe adverse consequences for the pregnant woman and her unborn baby. Pregnant women are at risk of delivering babies with low birth weight (below 2500g), and malaria increases the risk of maternal anemia that may lead to maternal death. In sub-Saharan Africa alone there are approximately 25-30 million pregnant women at risk of the disease. To date, medical anthropology research on malaria in pregnancy has been scarce. Little is known about the factors that affect pregnant women’s and their extended family members’ motivation and agency to seek treatment and preventive services from the antenatal clinic (ANC) which serves as a platform for implementation of the current malaria prevention strategies, namely intermittent preventive treatment and insecticide treated nets.
Yet it is acknowledged that prevention programmes depend largely on pregnant women’s participation and adherence with services. This applied medical anthropology research was planned to provide comprehensive understanding of factors affecting prevention of malaria in pregnancy from the perspective of pregnant women and their extended family members, as well as to provide insights into the interwoven factors at local, national and global level that affect planning and implementation of tailored and context specific malaria prevention programmes. Malaria is an enormous global health problem affecting mainly young children, pregnant women and adults with little or no immunity to malaria.
Malaria infection during pregnancy poses substantial risk to the mother, her foetus, and the neonate because pregnant women appear to be less capable of coping with and clearing malaria infections. Among the four types of parasites responsible for malaria in humans, Plasmodium falciparum is mainly responsible for morbidity and mortality in Ghana. Among pregnant women, malaria accounts for 28.1% of OPD attendance, 13.7% of admissions and 9.0% of maternal deaths. WHO recommends a multi-pronged approach to reduce the burden of malaria infection among all pregnant women. These are the use of Insecticide-treated nets (ITNs), the use of Intermittent Preventive Treatment (IPT) and case management of malaria illness.
1.2 STATEMENT OF THE PROBLEM
Malaria is caused by the protozoan parasite of the genus Plasmodium. It lives in the red blood cells and is transmitted by the female anopheles mosquito. Malaria is a disease with major health problems that has attracted global concern; hence, it is regarded as the most important of parasitic diseases. It is a household name in Nigeria. In Nigeria, like in other endemic areas, its severe and complicated effects are most common among infants and pregnant women. Pregnancy exacerbates malaria through a nonspecific hormone-dependent depression of the immune system. The protective antiplasmodial activity is suppressed at pregnancy, which has clinical consequences with important public health implications on pregnant women. Malaria infection leads to increased morbidity and mortality and the delivery of premature infants with low birth weights due to intrauterine growth retardation (IUGR) that may have been as a result of placental parasitisation. Malaria infection is significant in Africa where its fatality as a result of virulent Plasmodium falciparium is a far greater problem than in most parts of the world.
Pregnant women should be adequately informed on how to recognise the symptoms of malaria in their body especially during pregnancy, which is a critical period for women. Studies in West Africa have shown that the persistent failure of some intervention methods in health care delivery has been attributed to complete reliance on only clinical and laboratory diagnosis methods. Finally several researches have been carried out on the prevention and control of malaria in pregnancy women. But not even a single research has been carried out on the awareness of malaria in pregnant women in yola north L.G.A of Adamawa.
1.3 AIMS AND OBJECTIVES OF STUDY
The main aim of the study is to determine the awareness of malaria in pregnant women. Other specific of the study includes;
1. to determine the effect of malaria in pregnant women in yola north L.G.A of Adamawa.
2. to determine the causes malaria in pregnant women in yola north L.G.A of Adamawa.
3. to determine the extent to which malaria has affected pregnant women in yola north L.G.A of Adamawa.
4. to proffer possible solutions to problems.
1.4 RESEARCH QUESTIONS
1. What is the effect of malaria in pregnant women in yola north L.G.A of Adamawa?
2. What are the causes malaria in pregnant women in yola north L.G.A of Adamawa?
3. What is the extent to which malaria has affected pregnant women in yola north L.G.A of Adamawa?
4. What are the possible solutions to problems?
1.5 STATEMENT OF RESEARCH HYPOTHESIS
H0: There is no significant difference on the level awareness of malaria in pregnant women in yola north L.G.A of Adamawa.
H1: There is a significant difference on the level of awareness of malaria in pregnant women in yola north L.G.A of Adamawa.
1.6 SIGNIFICANCE OF STUDY
The study on the awareness of malaria in pregnant women will be of immense benefit to the entire yola north L.G.A of Adamawa. In the sense that, Government has taken several initiatives in the prevention of malaria and these include the free distribution of Long Lasting Insecticide Treated Nets (LLITNs) to pregnant women and children five (5) years and below, the subsidizing of the cost of LLITNs to the rest of the population, the subsidizing of the cost of artemisinin-based combination therapy used as first line treatment for uncomplicated malaria cases, and training in the community of local health assistance capable of managing uncomplicated malaria cases and providing adequate advices.
Despite the measures put in place by the government and its partners, malaria still remains a public health concern, a major cause of mortality and morbidity especially in pregnant women, nursing mothers, and children under five years in Ghana. In the Volta region of Ghana, malaria topped the morbidity indicators recording 617,191 cases representing 40.96% of the total Outpatient Department (OPD) attendance (GSS, 2010).
Ho municipality recorded 70,567 cases in 2014 (Ho Municipal Health Directorate, 2016). From Ho Polyclinic annual review (2016), 70% of the malaria cases reported comes from Godokpe community. Significant numbers of such cases were recorded in both pregnant women and nursing mothers. With the above figures showing devastating rate of malaria infection in Ho municipality, this study seeks to investigate the awareness of malaria prevention among people living in Godokpe community. Finally the study will contribute to the body of existing literature and knowledge to this field of study and basis for further research.
1.7 SCOPE OF STUDY
The study will focus on the awareness of malaria in pregnant women in yola north L.G.A is limited to Adamawa.
1.8 LIMITATION OF STUDY
Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.
1.9 DEFINITION OF TERMS
MALARIA: Is a life-threatening disease caused by parasites that are transmitted to people by mosquitoes.
PREGNANT: Is the time during which one or more offspring develops
AWARENESS: Is the ability to directly know and perceive, to feel, or to be cognizant of events.