THE INFLUENCE OF TRAINING OUTCOME AND COMPETENCY ON EFFECTIVE UTILIZATION OF MALARIA MICROSCOPY RESULT BY HEALTH PROFESSIONALS IN SOUTHEASTERN NIGERIA

BackgroundMalaria diagnosis in Nigeria was largely done based on clinical presentations until recently when the policy on parasitological confirmation of all suspected malaria cases before treatment was released by the government in 2011. One of the possible causes of over-diagnosis and over treatment of malaria in Nigeria is poor utilization of Malaria test results in health care delivery. This study demonstrates the influence of in-service training on malaria microscopy amongst medical laboratory scientists on the utilization of malaria microscopy results in a selected Government Health Facility in Nigeria.MethodThe base line study was conducted in 2014 while a follow up study where pre tested questionnaire on perception and utilization of malaria microscopy results by Health care providers in malaria case management were administered to end users of laboratory results in selected secondary health facilities; Basic malaria microscopy training was subsequently conducted for medical laboratory scientists working in these selected facilities in accordance with the World Health Organization (WHO) basic microscopy training manual. The training was followed up by a supportive supervision visit to the Medical Laboratories where other factors that can adversely affect microscopy results such as the necessary equipment and reagents for staining and visualization, good working conditions were addressed and put in place by the participating health facilities.Furthermore, During the basic and refresher training, Test scores was extracted using Microsoft Office Excel® 2010 template; data was cleaned and exported to Stata 11, Stata Corp. 2009. Stata Statistical Software: Release 11. College Station, TX: Stata Corp LP for data analysis. To assess the performance after the training intervention, paired-test was used to determine if there was any significant difference between the performance scores before and after the training and between the basic and refresher training.ResultThe study demonstrates a significant improvement in both the basic and refresher training mean parasite detection pre-and post-tests scores from 56.3% (95% CI 53.6-58.8%) to 77.7% (95% CI 74.4-80.2%) and 76.7 (95% CI 74.2-79.2%) to 91.2% (95% CI 88.3-94.1%)(P< 0.001). Comparing the baseline and follow up study, and the assessment of facilities’ malaria test request and utilization pattern within the study period,there was significant difference when comparing the rate of utilization of malaria result from the trained Medical Laboratory Scientists (p< 0.001).ConclusionThe increase in utilization of malaria microscopy result for effective case management of malaria in the study area was influenced by training outcome and competency of Medical Laboratory Scientists.