Adherence to the Revised National Malaria Case Management Guidelines Among Healthcare Workers at Mzimba District Hospital in Northern Malawi

Background: Management of severe malaria among children remains a challenge in sub-Saharan Africa, including Malawi. Therefore, this study examined the adherence to the national malaria case management guidelines among Malawian healthcare workers. Methods: This was a mixed-methods study that used purposive sampling to recruit nurses and clinicians in paediatric and nursery wards. Quantitative data were collected from 33 participants through a clinical observational checklist. Qualitative data were collected from 12 participants through in-depth interviews. Quantitative data were analysed using SPSS version 22.0, and qualitative data were analysed using thematic analysis. Results: The results indicated that 32/33 of the participants effectively treated under-five children with severe malaria, whereas 23/33 of the participants made incorrect diagnoses. Additionally, the general paediatric ward nurses did not appropriately monitor the patients. Most healthcare workers failed to provide adequate health education and follow-up appointments for the discharged children and their guardians due to a shortage of staff, lack of equipment and lack of commitment. Conclusion: The study suggests that there is poor adherence to the national malaria guidelines on the management of children with severe malaria.