The Guinea Worm Eradication Programme in the Atebubu District

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2003-08

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University of Ghana

Abstract

Guinea worm disease, otherwise known as Dracunculiasis Medinensis is a disabling disease in over 70 countries globally. Ghana ranks second to Sudan in the whole world. The Carter Center Foundation Global 2000 and the World Health Organization (WHO) embarked on a global eradicating campaign to eradicate the disease in the 1980s. The strategy recommended by WHO was based on a three-fold approach, interruptions of transmission, surveillance and certification. In Ghana the Guinea Worm Eradication Programme (GWEP) started in 1989 with a national case search and recorded 179,556 cases from 6,515 endemic communities. The GWEP had success stories in the first five years after it experienced stagnation leading to the postponement of deadlines for eradicating guinea worm. The study sought to study the GWEP in Atebubu District by assessing the effectiveness of programme interventions to break transmission of guinea worm .It was conducted in three sub-districts, which were classified according to levels of endemicity as far as guinea worm is concerned. These districts are: Prang (High Prevalence); Atebubu sub district (Low Prevalence); Amanten sub district (Non-endemic). Both qualitative and quantitative data collection techniques such as observation, indepth interviews, Focus Group Discussions (FGDs), administration of a structured questionnaire and record reviews were used. The data was analysed employing a soft ware programme, Statistical Package for the Social Sciences (SPSS). The study found out that records on programme interventions were accurate and information from the field when compared with reports tallied. However, the documentation lacked very important information like achievements, challenges, best practices and lessons learnt. The GWEP is well managed in the sense that the GWEP team conducts weekly meetings to review its objectives and activities. There are continuous monthly meetings with the zonal coordinators, and village volunteers in endemic areas to update their knowledge about the programme. A large proportion of respondent s interviewed in the sub districts are illiterates and farm for a living. There are equal numbers of males and females. More than half (50%) are above 45 years. The households are very knowledgeable about guinea worm as a disease, its prevention and are also aware of the GWEP. It was also discovered in all the three sub-districts, that more males than females filtered their drinking water. Of those who filtered their water about half (51%) of them demonstrated the process very well. Almost all (99%) respondents drink cold food drinks, which were prepared with unfiltered water. Most of the communities did not have in place any guinea worm eradication programme. The GWEP activities are rife in the highly endemic areas. Respondents in the non-endemic areas are well informed about the programme because these areas were previously endemic. Records on activities in high and low prevalence areas are lacking in certain details such as challenges faced in the field, best practices and lessons learnt. However, for non-endemic areas, records are non existent. There tends to be a lot of focus on programmes in high and low prevalence communities, some passive surveillance is needed in the non-endemic areas. There were no records on supervisory visits by the District Coordinator even though village volunteers and zonal coordinators confirmed that they were visited at least twice a month. They also organized monthly meetings with village volunteers and zonal coordinators to review their activities. The GWEP team meets every week to review programme activities but do not document such important meetings. Records of NGO and other stockholders involvement were present. The study, therefore, recommends that records of weekly and monthly GWEP review meetings must indicate challenges, lessons learnt and best practices in the field; programme activities should be extended to non-endemic areas to prevent outbreaks of the disease in new communities. To this end, it is imperative that village volunteers and zonal coordinators in the low and non endemic areas should attend quarterly meetings to involve them in the GWEP activities; Hospital nurses should also be involved in the GWEP activities. Records of supervisory visits and check lists should be kept and updated; It is important that health education messages should be given in the various local languages particularly Konkomba, Busanga and Dagarti, since they form the majority; the DHMT should focus on all aspects of GWEP activities and also cultural practices. An example is hygienic methods of food preparation particularly, cold drinks/ foods, and the use of borehole water or filtered water where necessary.

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Thesis(MPH)- University of Ghana

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