Quality of Management of Severe Malaria Cases in Children under Five: A Case of Four Health Facilities in the Littoral Department in Benin

Background: Benin republic is a sub-Saharan African country endemic to malaria caused by Plasmodium falciparum. To reduce the death rate due to this scourge, it is essential to ensure quality care, especially for children under five years who are the most vulnerable. The main objective of this study is to assess the quality of severe malaria case management in patients under five years. Methods: Descriptive and analytical cross-sectional study was performed in health facilities in Cotonou city, the economic capital of Benin Republic. Study sample included 205 suspected cases of severe malaria among children aged under five years, in four health facilities. In each of hospitals, all children under five years with severe malaria presumption were enrolled in the study. Quality was assessed through five components: diagnosis, treatment, patient monitoring, counselling/advice, and patient’s follow-up. Based on the Benin Republic’s malaria case management standard protocol, the assessment criteria of each component were defined. Results: The sex ratio was 1.25 boys to a girl. The median of hospitalisation duration was 3 days with first quartile (Q1) = 2 and third quartile (Q3) = 5. Among 205 severe malaria cases included, 157 (76.59%) were not managed in accordance with the requirements of the national protocol of malaria case management. The different components of cases management are not all implemented during the care of patients. Conclusion: There is a need for training to health workers on implementation of severe malaria in children under 5 years protocol. Also, there is a need for investigation about factors associated with malaria protocol implementation.