Feature by Christabel Addo
Accra, Dec.5, - Ghana has over
the last decade recorded significant progress in general public health care
delivery and also a major decline in the malaria prevalence from the high level
of over 50 per cent in 2012 to 20.4 per cent in 2016.
These have resulted in major
drops in malaria cases and deaths by 75 per cent over the years.
In spite of Ghana’s progress and
that of many others in the sub-Region, the World Health Organisation (WHO) is
urging countries and partners to accelerate the pace of action towards malaria
prevention, especially in low-income areas with a high disease burden. This, it
said will help save lives and help sustain the gains made so far.
It admitted that although there
has been significant development in the general public health care delivery in
various regions, especially in sub-Saharan Africa, including Ghana, the current
slow pace of progress if maintained, would not yield the attainment of the
Sustainable Development Goals (SDGs), despite ongoing efforts and investments.
This is because most countries
are still confronted with serious health challenges, such as maternal
mortality, child deaths, poor adolescent sexual and reproductive health, as
well as malaria.
The WHO however applauds the hard
work done in malaria-endemic countries including Ghana, to bring down the
prevalence rate in the last decade, but said sustaining these achievements
would require extra efforts, investment
and double-up of strategies, to attain the envisaged global elimination.
The 2016 Ghana Malaria Indicator
Survey (GMIS), confirms that in terms of malaria specific mortality, out of
every 100 children admitted for the illness, fewer numbers were dying, and in
technical terms, the under-five malaria case fatality rate had been dropping
consistently showing a reduction from
14.4 per cent in 2000 to 0.32 per cent in 2016.
The 2016 World Malaria Report
also indicated that the rate of new malaria cases fell by 21 per cent globally
between 2010 and 2015, while death rates also fell by 29 per cent in the same
five-year period. In sub-Saharan Africa, case incidence and death rates fell by
21 per cent and 31per cent respectively.
The WHO further reports that in
sub-Saharan Africa, which shoulders about 90 per cent of the global malaria burden,
more than 663 million cases have been averted since 2001, with the use of
Insecticide-treated nets having had the greatest impact, accounting for an
estimated 69 per cent of cases prevented through control tools.
Dr Constance Bart-Plange, the Programme
Manager of the National Malaria Control Programme (NMCP), at the commemoration
of the 2017 World Malaria Day in April, acknowledged that malaria-related
deaths in all ages have reduced from 3,882 in 2010 to 1,264 in 2016,
translating into about 4.2 per cent.
She attributed the drop to the
various interventions put in place to address the health challenges of
especially vulnerable groups, which include children and pregnant women, saying
these efforts have yielded an increase in household ownership of Insecticide
Treated bed Nets (ITNs), from 3.2 per cent in 2003 to 72 per cent in 2016,
while the use of these nets by children under-five have also gone up from a low
3.5 per cent in 2003, to 52.3 per cent in 2016.
Dr Bart-Plange noted that these
achievements could not have been made without the collective efforts by
leadership and partnerships of stakeholders, whose efforts and resources have
been harnessed to address malaria in an effective, sustainable and accountable
manner.
Currently Intermittent Preventive
Treatment of malaria in pregnancy (IPTp) which is a full therapeutic course of
antimalarial medicine given to pregnant women at antenatal clinic visits, have
improved. IPTs help in the prevention of maternal malaria episodes, maternal
and foetal anaemia, placental parasitaemia, low birth weight and neonatal
mortality.
The WHO however recommends a
three-pronged approach for reducing the negative effects associated with
malaria in pregnancy, which are: prompt diagnosis and treatment of confirmed
infections, the use of Sulphadoxin-Pyrimethamine (SP) also known as Fansider in
the IPTp uptake, which has increased from 0.8 per cent in 2003 to 78 per cent
in 2016, and also the use of Long Lasting Insecticide Treated Nets (LLINs).
The malaria fight is therefore
one of the most inspiring health stories resulting from great investments and
strong partnerships leading to the dramatic progress against the disease over
the years.
Over the years, government, donor
agencies, health service workers, dedicated partners, civil society
organisations, the media, traditional and community leaders as well as the
communities themselves, have been working together to reached millions of
Ghanaians with effective malaria control strategies, supported by massive
deployment of logistics, such as the LLINs, Rapid Diagnostic Test (RTD) Kits,
and Artemisinin-based Combination Therapy (ACTs).
Yet malaria, which is a parasitic
disease transmitted through the bite of an infective female anopheles mosquito,
has remain a bane to the public purse, and a major public health concern, which
affect all ages of people, posing a greater risk for especially pregnant women
and children under five years of being infected with severe malaria infection
leading to often fatal outcomes.
Other African regions have also
made substantial gains in their malaria responses, but the disease remains a
major public health threat. In 2015 alone, the global tally of malaria reached
429 000 malaria deaths and 212 million new cases, with the death of one child
recorded every two minutes, according to the WHO.
"Any death from malaria-a
preventable and treatable disease- is simply unacceptable," says Dr Pedro
Alonso, the Director of WHO’s Global Malaria Programme.
The Ghana Health Service
presently rates malaria cases as number one at all Out-Patient Departments
(OPD) of health facilities across the country, even though the Strategic Plan
for Malaria Control in Ghana from 2014 to 2020, require all children under age
five, and pregnant women to sleep under an LLINs every night to prevent malaria
complications.
The vision of achieving Universal
Health Coverage (UHC) as recommended by the United Nations Sustainable
Development Goals (SDGs) has now become a political priority for many African
countries, but the difficulty is how to achieve these objectives.
Abstracts from a combined study
by researchers from the Institute of Statistical Social and Economic Research
(ISSER) of the University of Ghana Centre for Global Health Security, Chatham
House, and the Royal Institute of International Affairs, estimated that around
400 million people lack access to at least one essential health service and
that around 100 million are impoverished every year because of health care
cost.
Many women in Ghana, especially
those living in deprived communities, are often caught in a tangled web of
inequalities, and are confronted by a myriad of challenges that ranges from
socio-cultural, economic factors, access to swift transportation systems, to
the delays that occur at the community and health institutional levels.
The United Nations Population
Fund (UNFPA) in its mission has over the years been supporting governments to
achieve universal access to sexual and reproductive health- including family
planning services, and to realise reproductive rights, as well as reduce
maternal mortality to accelerate progress in the ICPD and SDGs agenda.
The UNFPA’s is currently
assisting governments implement various strategies aimed at delivering a world
where every pregnancy is wanted, where every childbirth is safe and every young
person’s potential is fulfilled.
Eliminating malaria therefore,
would involve three key concepts: Parasite clearance, largely through drugs or
a vaccine (a malaria vaccine does not yet exist, but some promising vaccines
are under development); Keeping out the mosquito vector that facilitates
transmission (such as spraying techniques) or blocking it from biting with the
use of insecticide-treated nets and repellents; Minimizing the importation of
the parasite that can be imported through human movements.
The 2016 GMIS suggests that to ensure
an efficient malaria control programme, it is necessary to evaluate the
attitudes and practices of people living in high risk areas. This, it said
would help to identify approaches for involving the full participation of the
community in surveillance and control activities such as early, prompt
treatment of confirmed cases.
It further indicates that the
Strategic Plan for malaria control in Ghana recommends that all suspected
malaria cases are confirmed in accordance with the T3 which involves Testing,
Treating and Tracking.
Making headway to sustaining the
gains made in malaria prevention would require multi-sectorial collaboration
and the effective use of scarce resources to reduce the prevalence with the
ultimate aim of eliminating it.
GNA
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