The impact of COVID-19 on implementation of mass testing, treatment and tracking of malaria in rural communities in Ghana: A qualitative study (original) (raw)
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BMC Public Health
Background: Malaria remains endemic in Ghana despite several interventions. Studies have demonstrated very high levels of asymptomatic malaria parasitaemia in both under-five and school-age children. Mass testing, treatment and tracking (MTTT) of malaria in communities is being proposed for implementation with the argument that it can reduce parasite load, amplify gains from the other control interventions and consequently lead to elimination. However, challenges associated with implementing MTTT such as feasibility, levels of coverage to be achieved for effectiveness, community perceptions and cost implications need to be clearly understood. This qualitative study was therefore conducted in an area with ongoing MTTT to assess community and health workers' perceptions about feasibility of scale-up and effectiveness to guide scale-up decisions. Methods: This qualitative study employed purposive sampling to select the study participants. Ten focus group discussions (FGDs) were conducted in seven communities; eight with community members (n = 80) and two with health workers (n = 14). In addition, two in-depth interviews (IDI) were conducted, one with a Physician Assistant and another with a Laboratory Technician at the health facility. All interviews were recorded, transcribed, translated and analyzed using QSR NVivo 12. Results: Both health workers and community members expressed positive perceptions about the feasibility of implementation and effectiveness of MTTT as an intervention that could reduce the burden of malaria in the community. MTTT implementation was perceived to have increased sensitisation about malaria, reduced the incidence of malaria, reduced household expenditure on malaria and alleviated the need to travel long distances for healthcare. Key challenges to implementation were doubts about the expertise of trained Community-Based Health Volunteers (CBHVs) to diagnose and treat malaria appropriately, side effects of Artemisinin-based Combination Therapies (ACTs) and misconceptions that CBHVs could infect children with epilepsy. Conclusion: The study demonstrated that MTTT was perceived to be effective in reducing malaria incidence and related hospital visits in participating communities. MTTT was deemed useful in breaking financial and geographical barriers to accessing healthcare. The interventions were feasible and acceptable to community members, despite observed challenges to implementation such as concerns about CBHVs' knowledge and skills and reduced revenue from internally generated funds (IGF) of the health facility.
PloS one, 2016
Seasonal Malaria Chemoprevention (SMC) is currently recommended for children under five in areas where malaria transmission is highly seasonal. We explored children's caregivers' and community health workers' (CHWs) responses to an extended 5-month SMC programme. Thirteen in-depth interviews and eight focus group discussions explored optimal and suboptimal 'uptake' of SMC to examine facilitators and barriers to caregivers' uptake. There did not appear to be major differences between caregivers of children with optimal and sub-optimal SMC uptake in terms of their knowledge of malaria, their perceptions of the effect of SMC on a child's health, nor their understanding of chemoprevention. Caregivers experienced difficulty in prioritising SMC for well children, perceiving medication being for treatment rather than prevention. Prior to the study, caregivers had become accustomed to rapid diagnostic testing (RDT) for malaria, and therefore blood testing for mal...
International Journal Of Community Medicine And Public Health, 2018
Background: Although control measures have achieved considerable success, malaria is still a major public health problem in Nigeria and sub-Saharan Africa. The malaria burden is more among vulnerable groups like pregnant women and under-five aged children. This study explored barriers affecting uptake of current malaria prevention interventions in Ibadan, Southwest Nigeria.Methods: The study was conducted using qualitative research methods between May and August 2016 among community residents in Ibadan, Oyo state-Nigeria. Six focus group discussions (FGDs) and 16 in-depth interviews (IDI) were conducted with community members who were purposively selected and consented to participate in the study. The participants were grouped into six homogenous focus groups which included; pregnant women, mothers of under-five children, husbands, fathers, civil society members, and health staff such as hospital manager, nurses, pharmacist, medicine vendors, doctors, state program staff and nationa...
Pilot and Feasibility Studies, 2021
Background A randomised controlled trial (RCT) on integrated malaria prevention, which advocates the use of several malaria prevention methods holistically, has been proposed. However, before conducting an RCT, it is recommended that a feasibility study is carried out to provide information to support the main study, particularly for such a complex intervention. Therefore, a feasibility study for an RCT on integrated malaria prevention in Uganda was conducted. Methods The qualitative study carried out in Wakiso District employed focus group discussions (FGDs) and key informant interviews (KIIs) to explore community willingness to participate in the RCT as well as assess stakeholder perspectives on the future study. The participants of the FGDs were community members, while the key informants were selected from malaria stakeholders including Ministry of Health officials, health practitioners, local leaders, district health team members, and community health workers (CHWs). Thematic a...
Ghana medical journal, 2014
Malaria remains a major cause of morbidity and mortality in Ghana. Very little attention was paid to community participation in malaria control in the past and this has affected most of the desired outcomes. The recent recognition of the importance of community participation in malaria control had informed the implementation of Intermittent Preventive Treatment of Childhood Malaria (IPTc). The intervention was implemented in the Shime sub-district of the Keta District in Ghana and this paper reports the evaluation of the community involvement aspect of the project. Semi-structured questionnaire were administered to 105 randomly selected caregivers. A focus group discussion was organized for nine Community Assistants (CAs) and 16 in-depth interviews were conducted with opinion leaders. The tools were used to investigate community attitudes towards, level of awareness and acceptance of the intervention. The benefits of the project and the preferred mode of drug delivery were also inve...
International Research Journal of Public Health, 2017
Background: The use of antimalarial drugs and the prevention of man and vector contact remain the major control and prevention strategy of malaria until the availability of effective and safe vaccine. In Africa, one of the major strategies to malaria control and prevention is the home based malaria strategy through which trained community drug distributors identify and provide antimalarial drugs to children under five years with fever. This research aims at exploring the capacity, performance, and motivation of CBAs in Tamale Metropolis, Northern region, Ghana. Methodology: A Survey, in-depth interviews and short ethnographic techniques were conducted among 104 CBAs who were trained and given logistical support to assess and treat children less than five years with malaria presumptively at home. Participants were selected randomly and represented urban, peri-urban and rural settings. Results: 96.2% of respondents identified malaria by presence of fever while 92.3% used fever as a cardinal sign. More than 82% of participants provided early treatment in all the three location. 64.4% of participants administered the correct number of days while 32.7% administered daily doses correctly, only 24% of CBAs knew that the Antimalarial medications they use have some side effects. 77.9% knew when to repeat drug dose when child vomit or when parent forget to give the dose. Most of the participant had registers and were
2012
Background. In line with increased advocacy for implementation of malaria interventions at community level, universal net coverage has become a prominent intervention in Lilongwe, Malawi. However, beliefs and perceptions about malaria interventions have greatly affected the implementation of interventions at community level. This study explored the perception of community health workers in Lilongwe on barriers to effective malaria control service delivery and utilisation at the community level. Methods. Data on perceived beliefs and misconception about malaria interventions were collected through qualitative interviews. Qualitative data were analysed using the Framework Analysis approach. Results. The study identified a number of factors that health workers cited as barriers and challenges to effective implementation of malaria interventions in Lilongwe. These related to health workers' assimilation of community's beliefs and traditions; beliefs about causes of malaria contrary to known biomedical causes of malaria; beliefs about traditional methods of malaria prevention and treatment; beliefs about insecticide-treated nets (ITNs) as a cause of infertility among married couples; beliefs about alternative uses of ITNs; and lack of understanding about selective susceptibility to malaria infections. Conclusion. This study demonstrated, in part, that beliefs and perceptions about malaria intervention evolved through ecological correlations and requires education that fully explains how such correlations arose other than simple disproof as myths. A participatory approach in designing and delivering malaria interventions at community level complemented with the inclusion of traditional interventions results in better collaboration and is more likely to be accepted by members of the community as it provides cultural synthesis.
Malaria Journal, 2018
BackgroundThere is growing interest to add mass drug administration (MDA) to the already existing malaria prevention strategies, such as indoor residual spraying (IRS). However, successful MDA and IRS requires high population-wide coverage, emphasizing the importance of community acceptance. This study’s objectives were to identify community-level facilitators and barriers during the implementation of both MDA and IRS in communities with high malaria transmission intensity.MethodsThis was a qualitative study conducted in two sub-counties in Katakwi district. Kapujan sub-county residents received two rounds of IRS and MDA while Toroma sub-county residents received two rounds of IRS only. Key informant interviews and focus group discussions were conducted with key influential district and sub-county personnel and community members. Data were analysed using thematic analysis. Transcripts and interview notes from the in-depth interviews were analysed using a coding scheme developed from...
BMC International Health and Human Rights, 2009
In Africa, an estimated 300-500 million cases of malaria occur each year resulting in approximately 1 million deaths. More than 90% of these are in children under 5 years of age. To identify commonly held beliefs about malaria that might present barriers to its successful treatment and prevention, we conducted a systematic review of qualitative studies examining beliefs and practices concerning malaria in sub-Saharan African countries.
BMC Infectious Diseases
Introduction The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in a major breakdown of health service provision in the fight against neglected tropical diseases (NTDs). COVID-19 may impact NTDs service delivery in varied ways. As the Ghana NTD programme planned to resume MDA activities, we examined the COVID-19 related perceptions and practices among some community members and frontline health workers for NTD control activities in the country. Methods The study was conducted in seven communities in the Ahanta West district of Ghana. This was a qualitative study using in-depth interviews (IDI) and focus group discussions (FGDs) for data collection. Participants were purposively selected from varied backgrounds to represent both beneficiaries and service providers directly involved in NTD programme implementation. Trained and experienced qualitative data collectors conducted the FGD and IDI sessions in the local Twi language, while health worker sessions were conducted in ...