Improving Test-based Treatment of Malaria in Peripheral Health Facilities through Mentorship in Ghana

Aug 2015
“I wish I had this opportunity prior to my posting to my CHPS zone. This training has indeed been an eye-opener, and I’m going to be a great ambassador of test-based treatment henceforth.” - Amansie West, Community health officer (CHO)
Credit: William Brieger/JHPIEGO

Adherence to negative malaria test results remains a major problem in Ghana, particularly at peripheral level health facilities. Many providers at these facilities, and those working at the community level, have not benefited from rigorous training in the correct diagnosis and management of malaria and other febrile illnesses. As a result, patients with fever, including those with malaria, are often treated on the basis of their symptoms alone without a confirmed diagnosis. This contributes to overuse of antimalarial medicines.

In 2004, the Ghana Health Service and the National Malaria Control Program launched the Community-based Health Planning and Service (CHPS) Initiative to improve access to health care in peripheral health facilities, given that these are the first point of entry into the health system for much of the population. To support this effort, the President’s Malaria Initiative (PMI) funded a pilot program in 2014 to attach community health officers (CHO) to district health facilities in order to provide them with mentorship opportunities and improve their case management skills for febrile patients. Seven districts from five regions were selected to participate based on their performance from a first round of supportive supervision visits. CHOs participated in an intensive five-day skills-building training and mentoring internship with district health facility staff to strengthen their ability to provide correct diagnosis and treatment for fever cases, while improving communication and linkages between lower level and referral facilities. To assess CHO performance, the project designed a checklist, in line with the World Health Organization’s Integrated Management of Adolescent and Adult Illnesses guidance to assist the project team and stakeholders to gauge the success of the training after the conclusion of the pilot.

Initial assessments of the pilot are promising, and PMI continues to work closely with the Ghana Health Service, health facilities, and communities to improve services and support CHOs on the front lines. The Ghana Health Service, the National Malaria Control Program, and regional and district managers that support and monitor the pilot have hailed this effort as an appropriate strategy to prepare CHOs prior to posting them in their respective facilities and communities and have committed to including it within the Ghana CHPS Initiative.

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