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.
To support the achievement of global leprosy targets, there is a need for improved leprosy data management and mapping. At the 2022 International Leprosy Congress, the Global Leprosy Mapping Initiative was announced with a goal to develop tools, processes, and best practices to support ministries of health to map leprosy, with a focus on capacity building, sustainability, and knowledge exchange to facilitate the achievement of global leprosy targets. This initiative will build on lessons learned from the Global Trachoma Mapping Project, bringing together a diverse group of leprosy stakeholders to support the development of global leprosy data and mapping standards, tools, and resources. This approach will allow for greater efficiencies in targeting interventions, facilitate advocacy and fundraising, and will support countries on the path to achieve zero leprosy. As the project is implemented over the next 3 years and beyond, partners are invited to engage and collaborate.
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