Professional Management of Malaria in Pregnancy Among Midwives in Tertiary Hospitals in Oyo State, South West Nigeria

Midwives serve as critical gatekeepers for the prevention and management of malaria in pregnancy in Nigerian tertiary hospitals, yet evidence suggests significant variability in their adherence to WHO and national guidelines for intermittent preventive treatment and case management. This study assesses the professional management of malaria in pregnancy among midwives in tertiary hospitals in Oyo State, South West Nigeria. A cross-sectional design was used, targeting 200 midwives from three tertiary hospitals including the University College Hospital Ibadan, Ladoke Akintola University of Technology Teaching Hospital, and a state referral centre. Data collection involved structured knowledge questionnaires, clinical scenario assessments, review of antenatal case documentation, and focus group discussions. Key domains assessed included knowledge of IPTp dosing schedules, timing of the first dose, contraindications, management of confirmed malaria in pregnancy, and documentation practices. Current literature from 2020 to 2024 identifies IPTp underutilisation and dosing errors as persistent problems in Nigerian tertiary maternity settings, partly driven by knowledge gaps and drug stockouts. This study generates a knowledge-practice gap analysis and identifies system-level barriers to guideline adherence. Recommendations will be submitted to the Oyo State Ministry of Health and the Nursing and Midwifery Council of Nigeria for continuing professional development curriculum update. Keywords: malaria in pregnancy, midwives, intermittent preventive treatment, Oyo State, professional practice.