Abstract:
Background: According to the World Health Organization (WHO) 2012 report, the African Region carries a disproportionately high share of the global malaria burden. The disease burden prompted the WHO Global Malaria Programme to initiate the Test, Treat and Track (T3) policy in 2012, which Ghana adopted to scale up malaria testing, increase treatment with antimalarials and strengthen the malaria surveillance system. Seven years after the adoption of the policy in Ghana, it is prudent to assess the adherence towards the T3 malaria policy at different health facility levels in Ghana.
Method: The study used secondary data from the Coffey International T3 Malaria evaluation for the analysis. This is a descriptive cross-sectional study using a quantitative method, conducted in six districts in three regions of Ghana’s three malaria epidemiologic zones: the northern savannah, the tropical rainforest, and the coastal savannah/mangrove swamps. Data was collected using a standard questionnaire and analyzed using descriptive statistics and Pearson’s chi-squared test to determine associations. Data from healthcare providers and client-exit interviews from 28 health facilities were used for the analysis.
Result: The study assessed 28 health facilities consisting of 16 (57.1%) CHPS, 5 (17.9%) Government Hospitals and 7 (17.9%) Health Centres. Also, 590 clients from various facilities, made up of 66.4% females and 33.6% males was interviewed. Overall, the study revealed 98.1% knowledge and 96.4% adherence levels among health facilities. However, the proportion of total recipients of T3 at the client’s level was 28.0% due to a lower number of tracking clients to complete the policy guidelines process. The study found a significant association between age groups of clients and the level of compliance with the policy.
Conclusion: The research revealed higher knowledge and adherence level of the T3 policy at the facility levels during the survey. However, the study showed that though the percentage of testing and treating was found to be at a higher level, the number of clients who received the three processes (Test, Treat and Tracked) was low (28%). This was due to the inability of a greater proportion of clients to complete the tracking component of the policy as stipulated in the implementation guideline. There was an association between the age of clients and compliance with the T3 policy.
Recommendations: The study recommends that the National Malaria Control Programme (NMCP) and the GHS undertake measures to train healthcare providers, increase monitoring and supervision. These two agencies should ensure regular supply of RDTs and Artemisinin Combination Therapies (ACTs) to promote adherence. Furthermore, there is the need to undertake further research on the policy implementation processes across the various cascade of care.