Assessing malaria control programs in Accra

Ortis Yankey, Accra Community Manager
Accra, October 22, 2015

With this month's forum aimed at assessing impact, this article focuses on an urban malaria control program in Accra. The Ghana Health Service gathers periodic data on malaria cases reported at various hospitals in the country. Malaria is the leading cause of morbidity and mortality in Ghana, accounting for about a third of outpatient cases noted each year. Most studies on malaria prevalence rates have been focused on rural areas, where the prevalence rate of the disease is perceived to be higher than urban areas. However in 2014, The Ghana Health Service in partnership with USAID conducted a multi-centric study of the malaria burden within Accra and other urban areas, which was aimed at helping health practitioners to be better informed about urban malaria in Ghana and to contribute to policy-making and public health programming. The study was also aimed at assessing the disease prevalence rate among various social groups within Accra and the way forward for controlling the disease.

A public health triangulation approach was used for this study to assess the malaria burden in the major cities and also to better understand the implications of these findings for malaria control in Ghana. The approach involves the process for reviewing, synthesizing, and interpreting secondary data from multiple sources that inform public health decisions. The major sources of data included household surveys, both those with a nationwide sample and those focused exclusively on Accra, data reported monthly by health facilities in Ghana, and reports of previous studies documenting the burden of urban malaria in specific communities. This provided a means of validating results to increase credibility in ensuring a more detailed understanding of the findings.

Among other things, the study found out that malaria transmission and prevalence vary greatly within neighbourhoods of Accra. Individuals from poor neighbourhoods were more susceptible to the disease than the average person in Accra. The prevalence of the disease in children of poor household is 50 percent to 100 percent higher than the average for other children within the city. Pregnant women from poor neighborhoods were also more prone to the disease. However, messages had been sent regarding malaria control. The study also found out that there were important shortcomings in malaria control activities. Urban poverty was cited as the major hindrance in the inability of the poor to access quality health care: inadequate use of anti-malaria drugs, lack of insecticide mosquito nets, and less use of laboratory testing to diagnose malaria cases before providing medical prescriptions.

The study therefore recommended that urban anti-malaria programs should promote the use of Insecticide treated nets for pregnant women and children as well as the use of anti-malaria drugs and rapid laboratory diagnoses of malaria cases. Furthermore, it also concluded that community-based malaria control interventions to achieve these objectives should target the poorest urban households, and those with a higher burden of malaria.

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