Effectiveness of the National Malaria Control Programme in Akwapim South Municipality

Abstract

Malaria control has received significant attention in the Akwapim South Municipality yet remains the highest cause of ill-health among the people. Not only must interventions be put in place but they must actually be effective in ensuring that malaria morbidity and mortality are eliminated. There have been series of strategies that have been implemented under the malaria control programme to control and prevent malaria. Despite the fact that interventions have been introduced, their effectiveness is in doubt since malaria still remains a major public health problem in the Akwapim South Municipality. The study attempts to evaluate the effectiveness of this programme in terms of its outcomes on access to these interventions, knowledge on malaria and the overall impact of the strategies on trends of malaria prevalence among households in Akwapim South Municipality. The study used the cluster based sampling technique to solicit the views of 200 households using a questionnaire. Also, interviews with 20 health workers provided crucial qualitative data as well as the review of secondary data from the district and regional health offices. Other qualitative methods employed were in-depth interviews and focus group discussions with programme stakeholders and households who were the beneficiaries. The results show a significant increase in terms of coverage of most of the strategies. There is increased possession of insecticides treated nets (74%) of the 100% target by 2015. Despite the increases on access to the ITNs, their utilization remains low among households. All pregnant women who visited health facility were put on Intermittent Preventive Treatment for pregnant women as targeted to achieve by 2015. There was evidence of limited coverage of indoor residual spraying and likewise there was low access to prompt treatment of malaria. Overall, the malaria situation remains high with a prevalence of 67% of households reporting of malaria in the past two weeks. The study indicates a decrease in terms of malaria mortality. Against the target of achieving a 100% for all malaria cases confirmed before treatment by 2015, the findings showed that only 50% of malaria cases were confirmed before treatment. There was also an over concentration on the curative aspect of malaria cases than measures for prevention which are more likely to ensure sustainable malaria control. The key challenges of the programme included inadequate funding, low staffing and low involvement of the people. Poor involvement of the people led to low levels of acceptability. The study concludes by recommending that interventions of the malaria control programme in Akwapim South Municipality be repositioned in a way that increases the performance and effectiveness of the programme.