The Guinea Worm Eradication Programme in the Atebubu District
Date
2003-08
Authors
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Publisher
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.
Description
Thesis(MPH)- University of Ghana