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ProMPT Ghana Project Celebrates National Malaria Control Program Achievements
The Promoting Malaria Prevention and Treatment (ProMPT) Ghana project celebrated successful completion of its mission with government and local partners last week, after four years of strengthening Ghana's efforts to tackle malaria. ProMPT's support made significant and broad-based contributions to the achievements of the country's National Malaria Control Programme (NMCP), part of the Ghana Health Service (GHS). These contributions include supporting the NMCP to improve malaria prevention and treatment, mobilize communities to take action to protect themselves and others, and spread evidence-based practices across the country. Funded by the United States Agency for International Development (USAID) under the President's Malaria Initiative (PMI), ProMPT was managed by URC with its partners the Population Council and Malaria Consortium.
Combating malaria, a major cause of sickness and death in Ghana, requires comprehensive, integrated programming. ProMPT's approach comprised four major components: 1) preventing malaria through use of bed nets, 2) mobilizing communities to engage in malaria prevention and control activities, 3) improving management of simple and severe malaria cases and malaria in pregnancy, and 4) strengthening health systems for monitoring and evaluation.
Preventing Malaria through Bed Net Use
Sleeping under nets is key to preventing malaria: long-lasting insecticidal nets (LLINs) kill on contact the mosquitoes that transmit malaria. To help reach NMCP's goal of universal LLIN coverage (one net for every two people), ProMPT and NMCP developed an innovative model for engaging other partners and donors, civil society organizations, community leaders, and volunteers to carry out regional door-to-door LLIN delivery and hang-up campaigns.
Such campaigns provide opportunities that other distribution strategies do not: while hanging bed nets over sleeping places, volunteers also inform residents about the benefits of routinely sleeping under the nets and teach people how to care for them. ProMPT, with other GHS partners, supported the NMCP to carry out the campaigns, with achievements that included:
- Distributing more than 12 million LLINs nationwide.
- Helping increase net ownership and use in project-supported regions. According to recent government health surveys, the percentage of children sleeping under LLINs increased from 11% to 42% in Northern Region, from 36% to 60% in Eastern Region, and 40% to 70% in Volta Region between 2008 and 2011.
- Receiving an award for Lead Innovator for LLIN distribution in 2011 from the Alliance for Malaria Prevention.
- Supporting a demonstration project to test approaches for routine, continuous distribution (as opposed to once-only campaigns), including school-based distribution of LLINs in partnership with the GHS, which enabled over 181,000 students and primary school teachers to receive nets.
ProMPT developed this door to door hang-up campaign model to mobilize partners, donors, civil society organizations, and volunteers to distribute and hang up more than 12 million bed nets nationwide.
Mobilizing Communities to Engage in Malaria Prevention
Because malaria is such a common disease in Ghana, many people are unaware of the dangers it presents and do not know how to prevent it. ProMPT supported a number of social mobilization activities to educate Ghanaians about malaria prevention and treatment and to encourage communities to take an active role in combating the disease. ProMPT also assisted the NMCP and GHS to increase demand for malaria prevention and control activities and establish their sustained use. Successes included:
- Sponsoring a nationwide multi-media campaign with the USAID/Behavior Change Support project promoting malaria prevention. In addition, ProMPT produced and aired more than 11,000 radio spots in five local languages throughout seven regions.
- Playing a key role in coordinating nationwide malaria communication, including finalizing and distributing an updated national malaria behavior change communication strategy.
- Supporting the training and orientation of more than 4,500 opinion leaders, including traditional chiefs and queen mothers, clergy members, trade union leaders, and media journalists, who shared malaria prevention and control messages with their constituencies.
- Providing sub-grants to and developing the capacity of 33 Ghanaian NGOs to promote malaria prevention and treatment in 33 districts in eight regions and work with district health management teams to share resources and implement joint activities. The NGOs trained community health volunteers, who reached more than two million community members through these grassroots efforts.
Above: Drama entertains and engages communities while portraying healthy behaviors. Below: Grade 2 students at Mampong Primary School display insecticide treated nets they received as part of a free net distribution program in Ghana.
Improving Case Management and Malaria in Pregnancy
ProMPT strengthened the capacity of Ghana's health facilities to ensure that health care workers learn how to effectively manage simple and severe malaria cases, with a focus on children under five, and malaria in pregnancy (MIP). Malaria infection during pregnancy in particular poses substantial risk to the mother and her unborn or newborn child. The project supported the NMCP in:
- Providing training and training materials for more than 10,000 of Ghana's health workers in malaria case management and MIP.
- Developing and distributing 29,000 copies of a job aid that guides health workers on protocols for MIP and intermittent preventative treatment of malaria during pregnancy (IPTp) data monitoring. In 2011, Ghana achieved some of the highest rates in Sub Saharan Africa of pregnant women receiving a second dose of IPTp, at more than 60% (see graph below).
- Training 642 supervisory staff from seven regions in supportive supervision and providing grants to enable them to effectively monitor, evaluate, and continuously coach health workers to correctly manage malaria and MIP. To date, approximately 21,000 health workers from 2,000 health facilities have received a supervisory visit. Most facilities receiving supervision developed action plans to address key issues related to MIP and case management.
- Working closely with the GHS Institutional Care Division to provide monitoring and coaching support to regional and district teams implementing supportive supervision in seven regions. This collaboration will help to institutionalize supportive supervision within GHS.
- Providing training and materials for over 2,500 community health officers and community-based agents in community case management of malaria.
Strengthening Health System Response and Monitoring and Evaluation (M&E)
Good quality malaria data help decision makers, policy makers, program managers, and health workers to understand the malaria situation and take the actions needed to control it. ProMPT supported the health system in building its capacity to monitor and evaluate the national malaria program. Key results included:
- Equipping the NMCP to use statistical software and conduct evaluations of national malaria projects. In addition, a ProMPT-supported M&E advisor was placed at the NMCP to contribute to leadership and capacity building.
- Supporting regions and districts in managing their data by providing 45 computers, distributing over 15,000 consulting room patient registers, and training over 1,300 facility-based health workers in using these registers to improve data quality. The project also facilitated malaria data review meetings for exchange of best practices within and across different regions.
- Collaborating closely with the Policy, Planning, Monitoring, and Evaluation Unit of the GHS and the NMCP to train health information officers in seven regions in producing malaria data bulletins and in assessing the quality of malaria data and overall documentation within the regions.
March 08, 2013