Tailoring mass drug administration to context: implementation research is critical in achieving equitable progress in the control and elimination of helminth neglected tropical diseases in sub-Saharan Africa
Country Manager: Nana-Kwadwo Biritwum
Ghana has a Master Plan for Neglected Tropical Diseases (NTDs) that was finalised in 2013. It is in line with WHO/AFRO and Ministry of Health strategic objectives. It is comprehensive and involves all NTDs which are endemic in Ghana. Ghana has a population of 25 million. Each region of Ghana is endemic for at least three of the major NTDs.
Lymphatic Filariasis is endemic in 9 of the 10 regions and the programme was fully scaled up in 2006. However, morbidity management is limited. Onchocerciasis is in 9 out of the 10 regions. Soil Transmitted Helminths are endemic to all districts. Every school aged child is de-wormed at least once a year. They have completed four rounds of Mass Drug Administration for Schistosomiasis with good coverage. Trachoma is endemic in two regions, only one community was treated in 2014 and post-Mass Drug Administration surveillance now under way.
There is a single annual planning process with integrated implementation of Mass Drug Administration. The goal of the Master Plan is the establishment of an integrated NTD programme as part of the poverty alleviation process through preventative chemotherapy and case management. The country needs to effectively and efficiently scale down Lymphatic Filariasis and Trachoma and strengthen institutional care, including for mental health.
The Ghanaian government try to make sure that communities take a lead role, particularly for Mass Drug Administration and that planning and implementation of all diseases are integrated and coordinated. Operational research is very important to the programme.
The NTD programme has low visibility and as a result better endowed programmes benefit more from the work of Community Health Workers, such as Community Drug Distributors. Ghana faces challenges in synchronising funding and logistics among the various development partners that fund the programme. Programmes for urban Mass Drug Administration still need development and the country has hot spot areas for Onchocerciasis and Lymphatic Filariasis.