Evaluating the availability and quality of services for lymphatic filariasis morbidity in Ghana.

Autor: Edmiston M; American Leprosy Missions, Greenville, South Carolina United States of America., Atinbire S; American Leprosy Missions, Greenville, South Carolina United States of America., Mensah EO; Ghana Neglected Tropical Disease Program, Accra, Ghana., Mensah E; FHI 360, Durham, North Carolina., Alomatu B; Ghana Neglected Tropical Disease Program, Accra, Ghana., Asemanyi Mensah K; Ghana Neglected Tropical Disease Program, Accra, Ghana., Palmer S; FHI 360, Durham, North Carolina.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2023 Jun 12; Vol. 17 (6), pp. e0010805. Date of Electronic Publication: 2023 Jun 12 (Print Publication: 2023).
DOI: 10.1371/journal.pntd.0010805
Abstrakt: Background and Methodology: In districts where lymphatic filariasis (LF) is endemic, the goal is to provide 100% geographical coverage of the essential package of care. Additionally, countries seeking elimination status must document the availability of services for lymphoedema and hydrocele in all endemic areas. To do this, the WHO recommends conducting assessments of the readiness and quality of services provided to identify service delivery and quality gaps. This study used the recommended WHO Direct Inspection Protocol (DIP), which consists of 14 core indicators related to LF case management, medicine and commodities, staff knowledge and patient tracking. The survey was administered in 156 health facilities across Ghana designated and trained to provide LF morbidity management services. Patient and health provider interviews were also conducted to assess challenges and feedback.
Principal Findings: The highest performing indicators across the 156 surveyed facilities were related to staff knowledge; 96.6% of health workers correctly identified two or more signs and symptoms. The lowest scoring indicators concerned medication availability, with the two lowest scoring indicators in the survey being availability of antifungals (26.28%) and antiseptics (31.41%). Hospitals performed best with an overall score of 79.9%, followed by health centers (73%), clinics (67.1%) and CHPS compounds (66.8%). The most commonly reported challenge from health worker interviews was lack of medications and supplies, followed by a lack of training or poor motivation.
Conclusions and Significance: The findings from this study can help the Ghana NTD Program identify areas of improvement as they seek to achieve LF elimination targets and continue to improve access to care for those with LF-related morbidity as part of overall health systems strengthening. Key recommendations include prioritizing refresher and MMDP training for health workers, ensuring reliable patient tracking systems, and integrating lymphatic filariasis morbidity management into the routine healthcare system to ensure medicine and commodity availably.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Edmiston et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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