AN ASSESSMENT OF THE PREVALENCE AND MANAGEMENT OF MALARIA AMONG PREGNANT WOMEN: A CASE STUDY OF PRIMARY HEALTH CENTRES IN OGBOMOSHO, OYO STATE

AN ASSESSMENT OF THE PREVALENCE AND MANAGEMENT OF MALARIA AMONG PREGNANT WOMEN: A CASE STUDY OF PRIMARY HEALTH CENTRES IN OGBOMOSHO, OYO STATE

CHAPTER ONE: INTRODUCTION

1.1 Background of the Study

Malaria remains one of the most pressing public health challenges in sub-Saharan Africa, where it continues to cause high morbidity and mortality, particularly among vulnerable populations such as pregnant women and children under five. In Nigeria, malaria is responsible for nearly 60% of outpatient visits and 30% of hospitalizations (National Malaria Elimination Programme [NMEP], 2022). Among pregnant women, the disease presents grave risks to both maternal and fetal health, including anemia, miscarriage, stillbirth, low birth weight, and in severe cases, maternal death (World Health Organization [WHO], 2023). The vulnerability of pregnant women to malaria stems from immunological changes during pregnancy that reduce resistance to Plasmodium falciparum, the most virulent malaria parasite in Africa.

Ogbomosho, a semi-urban town in Oyo State, represents a critical area for understanding how malaria affects pregnant women at the grassroots level. With a growing population and numerous primary health centres (PHCs), the town plays a significant role in the delivery of maternal health services. Despite national policy frameworks such as the National Malaria Strategic Plan (2021–2025), there remain significant disparities in the accessibility and quality of malaria prevention and treatment at the PHC level. Preventive strategies such as intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine, insecticide-treated nets (ITNs), and effective case management are central to malaria control, yet their implementation often faces systemic challenges including drug stock-outs, insufficient staff training, and patient non-compliance (Adebayo et al., 2020).

Assessing the prevalence and management of malaria among pregnant women in PHCs across Ogbomosho is vital for understanding the real-world effectiveness of malaria control strategies. While antenatal clinics serve as an entry point for delivering malaria prevention, the extent to which services are utilized and the outcomes achieved vary widely depending on community awareness, healthcare infrastructure, and adherence to clinical guidelines. Moreover, there is limited empirical data specific to Ogbomosho that reflects both the burden of malaria in pregnancy and the effectiveness of available management practices.

This study aims to fill that gap by assessing both the prevalence of malaria among pregnant women and the quality of malaria management practices at the PHC level. It will provide evidence-based insights into the effectiveness of current interventions and inform targeted improvements in malaria control within maternal healthcare delivery in the region.

1.2 Statement of the Problem

Despite longstanding efforts to combat malaria in Nigeria, pregnant women in semi-urban areas like Ogbomosho continue to suffer disproportionately from the disease. Reports from local health facilities indicate that cases of malaria in pregnancy remain prevalent, contributing to adverse pregnancy outcomes. Yet, primary health centres—designed to offer preventive and curative care—struggle with structural and operational deficiencies that hinder effective malaria management. These challenges include irregular supply of antimalarial drugs, inconsistent implementation of IPTp, and limited community sensitization about malaria prevention during pregnancy (Yahaya et al., 2021).

Furthermore, malaria prevalence rates among pregnant women in Ogbomosho are not routinely documented, resulting in a significant data gap that impedes local health planning and policy development. The effectiveness of existing malaria interventions cannot be adequately assessed without empirical evidence on their uptake and outcomes. The persistence of preventable malaria-related complications among pregnant women suggests a failure in either healthcare delivery, patient behavior, or both. Therefore, this study seeks to investigate the prevalence of malaria in pregnancy and evaluate how well it is being managed across selected PHCs in Ogbomosho.

1.3 Objectives of the Study

To determine the prevalence of malaria among pregnant women attending PHCs in Ogbomosho.

To examine the malaria prevention and treatment strategies employed by PHCs.

To assess the challenges faced by healthcare workers and pregnant women in managing malaria during pregnancy.

1.4 Research Questions

What is the prevalence of malaria among pregnant women in selected PHCs in Ogbomosho?

What strategies are in place for malaria prevention and treatment during pregnancy?

What challenges hinder effective malaria management among pregnant women at the PHC level?

 

1.5 Research Hypotheses

H0₁: There is no significant relationship between malaria prevention strategies and the prevalence of malaria among pregnant women in Ogbomosho.

H0₂: The quality of malaria management practices at PHCs does not significantly affect maternal health outcomes in Ogbomosho.

1.6 Significance of the Study

The study provides a critical assessment of malaria prevalence and management during pregnancy in a semi-urban Nigerian context. Its findings will be valuable to policymakers, public health managers, maternal healthcare providers, and non-governmental organizations engaged in malaria control. The research will contribute to evidence-based improvements in PHC delivery, guide health education campaigns for pregnant women, and support advocacy for adequate resources to combat malaria in pregnancy.

1.7 Scope and Limitation of the Study

The study is limited to selected PHCs in Ogbomosho, Oyo State, focusing on pregnant women attending antenatal care services. It does not include secondary or tertiary health facilities. Limitations may include reliance on self-reported data, variations in healthcare worker competencies, and seasonal fluctuations in malaria transmission which may affect prevalence rates during the study period.

1.8 Operational Definition of Terms

Malaria: A mosquito-borne infectious disease caused by Plasmodium parasites, especially Plasmodium falciparum.

Prevalence: The proportion of a population found to have a condition at a specific time.

Malaria in Pregnancy: The occurrence of malaria infection during gestation, which poses risks to both mother and fetus.

Primary Health Centres (PHCs): Basic healthcare units providing first-level maternal and child health services, including malaria management.

1.9 Structure of the Study

This dissertation is organized into five chapters. Chapter One introduces the research problem and objectives. Chapter Two reviews related literature and theoretical frameworks. Chapter Three discusses the research methodology. Chapter Four presents the data analysis and findings. Chapter Five concludes the study with discussions, recommendations, and suggestions for future research.

 

References

Adebayo, A. M., Akinyemi, O. O., & Cadmus, E. O. (2020). Knowledge and utilization of malaria preventive measures among pregnant women in Ibadan, Nigeria. Annals of Ibadan Postgraduate Medicine, 18(1), 30–36.

National Malaria Elimination Programme (NMEP). (2022). National Malaria Strategic Plan 2021–2025. Abuja: Federal Ministry of Health.

World Health Organization. (2023). Malaria in pregnant women. Retrieved from https://www.who.int/news-room/fact-sheets/detail/malaria

Yahaya, M. T., Akinsola, H. A., & Bello, M. O. (2021). Malaria management practices in selected primary health centres in Nigeria: A qualitative study. Nigerian Journal of Parasitology, 42(2), 98–106.