Giving Compass’ Take:
• Emmanuel Attramah reports on women nurses in Ghana who are actively improving the diagnosis and treatment of malaria.
• How can other funders support efforts to engage existing healthcare providers to improve coverage and care of malaria patients?
• Read about one foundation’s approach to malaria.
The miracle of birth and the making of mothers has long fascinated Jenifer Adjei. Now an accomplished midwife at the Oda District Hospital in Ghana, Jenifer helps expectant and new parents plan for and cope with the arrival of their babies.
Through her work, Jenifer has become all too familiar with the adverse effects of malaria in Ghana—especially malaria in pregnancy (MIP). While Ghana has made substantial gains in driving down malaria, with malaria-attributable death declining from 19% in 2010 to 1.5% in 2018, the disease still kills far too many Ghanaians.
Prior to treating malaria, the World Health Organization (WHO) recommends confirmation of malaria by either microscopy or a rapid diagnostic test (RDT). Despite subscribing to WHO’s framework for scaling up malaria diagnostic testing, treatment, and surveillance, the reports from health facilities in Ghana indicate low health worker adherence to malaria testing before treatment.
Jenifer recounts times at her hospital where patients with fevers were treated with antimalarials often without any testing—a practice that increases the risk of antimalarial resistance and fetal loss among pregnant women, and also contributes to drug wastage.
To improve malaria service delivery, PMI Impact Malaria (IM) has supported Ghana’s National Malaria Control Program (NMCP) and Regional Health Administration (RHA) in organizing health facility-based malaria case management trainings for health workers. To determine which facilities were most in need of immediate trainings, IM collaborated with the RHA to prioritize districts and facilities with adverse malaria indicators—ultimately selecting 10 high burden facilities per region.
The training curriculum included the treatment of severe and uncomplicated malaria and MIP, using a quality improvement model that emphasizes the uptake of knowledge and the corresponding behavior change that should result. During the training, Jenifer and her hospital team identified non-testing of uncomplicated malaria before treatment as a challenge—with up to 60% of suspected uncomplicated malaria cases not tested before treatment. Three months after the training, presumptive treatment had dropped to zero.
Read the full article about treating malaria in Ghana by Emmanuel Attramah at PSI.
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