PMI Impact Malaria
PMI Impact Malaria in Ghana
PMI Impact Malaria (IM) is the flagship global service delivery project of the U.S. President’s Malaria Initiative (PMI). To fight malaria and save lives, IM is supporting Ghana’s national malaria control program (NMCP) in its efforts to strengthen malaria service delivery.
IM began working with Ghana’s NMCP in 2018 to improve malaria case management at the community and public facility levels, with an emphasis on protecting those who are most at risk—particularly young children and pregnant women.
To advance malaria service delivery in Ghana, IM focuses mainly on strengthening health provider competence, bolstering national diagnostic capacity, and enhancing the country’s ability to collect and use data for decision-making.
Malaria Country Context
In Ghana, malaria is endemic and perennial in all parts of the country with the entire population of about 29 million people at risk of infection. The malaria transmission season varies by geographic region, depending on the length of the dry season (December-February) during which there is little transmission. Seasonal variations are more pronounced in the north. The malaria parasite species Plasmodium falciparum causes the majority of infections.
Malaria continues to be a leading cause of illness and death in Ghana, particularly among children under the age of five. In 2018, the country reported about 7 million confirmed cases of malaria, compared to a World Health Organization (WHO) estimate of 7.8 million cases. During this same time, Ghana reported about 600 deaths due to malaria while the WHO estimate was 10,900 malaria deaths.
Between 2014 and 2016, confirmed malaria cases seen by health facility outpatient departments increased by 40%. Though the number of reported malaria cases has increased, this is largely due to improved access to health services, laboratory testing, and surveillance. Laboratory confirmation has improved significantly with 77% of malaria outpatient department cases confirmed in 2016. To prevent malaria in pregnancy (MIP), Ghana has also achieved the highest rate of intermittent preventive treatment for pregnant women (IPTp) in sub-Saharan Africa (78%), and made improvements in the rate of at least three doses administered after the first trimester (60%).
This is PMI Impact Malaria’s geographic coverage in Ghana:
PMI Impact Malaria has supported Ghana’s NMCP in achieving these key accomplishments:
Updated the national malaria case management guidelines to reflect current World Health Organization (WHO) and PMI standards on malaria service delivery, and disseminated this through seven job aides for case management and eight for malaria in pregnancy (MIP). The updated guidance is an essential resource to build health worker capacity and achieve increased competence of malaria case management.
Conducted routine reviews of data from Ghana’s health management information system (HMIS) to target facilities with the highest burden of malaria illness and death for facility-based malaria case management training. The NMCP reached a total of 310 high burden facilities that contribute between 75-95% of all malaria admissions and deaths, with trainings for approximately 60% of health workers involved in malaria case management. The NMCP is reviewing this approach to consider adapting it nationwide.
Implemented a new approach of supportive supervision at the facility level with standard automated checklists, called OTSS+, that focuses on continuous improvement of the competencies of health providers in case management, MIP, and diagnostics. Through this, the NMCP prioritized 43 high burden districts and facilities with poor performing malaria indicators. These facilities later demonstrated results of 97% of health workers obtaining competence in classifying malaria cases and 98% of health workers becoming familiar with intermittent preventive treatment in pregnancy (IPTp) guidance to prevent MIP.
Digitized the national laboratory OTSS+ tools to improve efficiency and promote timely analysis in 250 targeted facilities nationwide.
Photo Credit: PMI Impact Malaria, Ghana
Sources: PMI’s Ghana Country Brief, PMI’s Ghana Malaria Operational Plan FY 2020, 2019 World Malaria Report Ghana Country Profile, PMI Impact Malaria Ghana, and Ghana’s NMCP
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