NURSE-LED HEALTH EDUCATION AND SUPPORTIVE SUPERVISION OF HOME MANAGEMENT AND PREVENTION OF MALARIA AMONG UNDER-FIVES' MOTHERS IN EGBEDORE LOCAL GOVERNMENT, OSUN STATE NIGERIA

Abstract

Malaria contributes significantly to under-five mortality in Nigeria. Home management and prevention of malaria are key interventions for its control. However, effectiveness of these interventions require mothers's adequate knowledge and appropriate skills. The 2011 Disease surveillance and notification report of Osun state showed that the under-five malaria burden in Egbedore Local Government Area (LGA) was more than one third of the total in the state for all age groups in 2008, 2009 and 2010. This study was designed to assess effects of nurse-led health education and supportive supervision on knowledge and practice of home management and prevention of malaria by mothers of under-fives in the LGA. The study utilised quasi-experimental design. A four-stage sampling technique was used to select 837 mothers of under-fives in seven out of ten wards of the LGA .The mothers were randomly assigned into one Control Group (CG) and two intervention groups: Health Education Group (HEG) and Health Education and Supportive Supervision Group (HESSG). The study instruments were 11-item observation checklist to assess the structure of home environment and a 46-item structured questionnaire on knowledge and practice of home management and prevention of malaria. Data collection was at pre- (P1) and post-interventions at one month (P2), three months (P3) and six months (P4). Minimum and maximum scores obtainable for knowledge were 0 and 86 while practices were 0 and 58 respectively. Data were analysed using descriptive statistics, Chi square test and ANOVA at p = 0.05. Mothers' ages (years) were 31.9±5.6 (CG), 32.2±10.0 (HEG) and 31.2.±7.0 (HESSG). Married respondents per group were 91.0%, 92.5% and 94.6% for CG, HEG and HESSG respectively. There were no significant differences in their age, household size and number of under-fives across the study groups. The home environment significantly influenced home management and prevention of malaria. At PI, that were significant differences in overall knowledge scores of the study groups (CG: 38.34±4.4, HEG: 37.8± 5.0 and HESSG: 40.1±6.4). At P2, the differences in overall knowledge scores for the groups were significant (CC; 45.3±7.7, HEG:66.9±6.3 and HESSG: 73.3±5.1). At P3, the scores were significantly different (CG: 45.9±7.7, HEG: 74.6±4.7 and HESSG:73.6±5.8). At P4, there were also significant differences in the overall scores within the groups (CG: 45.8±7.7, HEG: 71.0±6.7 and HESSG: 74.1±5.8). The overall practice scores at P1 for the respondents were significantly different (CG: 18.6±4.2, HEG: 18.9±4.7 and HESSG: 20.9±4.6). At P2, the scores were significantly different (CG: 25.2±5.6, HEG: 34.9±4.1 and HESSG: 39.8±5.6). At P3, there were significant differences in the scores within the groups (CG: 25.2±5.6, HEG: 40.7 ± 6.1, and HESSG: 40.5±6.4). At P4, scores were also significantly different (CG: 25.1±5.6, HEG: 38.9±5.6 and HESSG: 40.8±5.0). Nurse-led health education and supportive supervision improved knowledge and practice of home management and prevention of malaria in Egbedore LGA. These approaches are therefore recommended.