Ghana

In 2023, Ghana implemented four cycles of Seasonal Malaria Chemoprevention (SMC) for children aged 3-59 months. The campaign took place from June to November/December, rather than the usual October start, due to delayed funds release. The initiative targeted 69 districts and successfully reached 85% of the intended population with all required doses.

Looking ahead to 2024, there are plans to administer five SMC cycles. Notably, there were no significant adverse events reported. However, an ongoing challenge remains in the form of inadequate funding, despite support from the Global Fund and PMI.

Generally, Ghana has low security risks. However, within one region, there has been a long-standing ethnic conflict. This conflict has been associated with loss of lives, displacement, and property destruction. This district has as such persistently had low SMC coverage. The region also has limited oversight by healthcare workers. To overcome these challenges, the NMP worked with local leaders and security agents to safeguard the lives of volunteers.

To avert security risks for volunteers, one of the main criteria for selecting volunteers is their ethnicity to avoid any flair-up of conflict. The team also used ICT to monitor daily coverage and react when coverage levels were very low. Government vehicles were also used to help with identification so that communities could relate with the volunteers. Due to frequent movement, it was difficult to estimate the target population. This also affects the management of adverse drug reactions as ethnic groups cannot cross territories to go to health facilities. Due to partaking in external activities by caregivers, caregivers must be reached before 6 AM or after 6 PM. However, Bawku has a curfew that starts at 6 PM which makes reaching caregivers difficult.

To adequately reach caregivers, the NMP would like to add a distribution point such as a marketplace. Supervisors also need to be regularly trained to ensure that they are aware of risks to address and responsibilities to adopt.