Community acceptability of Seasonal Malaria Chemoprevention of morbidity and mortality in young children: A qualitative study in the Upper West Region of Ghana

Abstract

Background Malaria remains a major public health problem, especially in sub-Sahara African countries. The Malaria Control Program of Ghana has implemented Seasonal Malaria Chemoprevention (SMC) intervention in the Upper West Region in 2015. This preventive drug has been recommended by WHO as very safe and effective in preventing malaria in children under five years. This study assessed community acceptability of the SMC intervention in the Lawra district of Northern Ghana. Methodology This was a qualitative study where focus group discussions and in-depth interviews were conducted with community-based health volunteers and parents whose children received the SMC drug. Purposive sampling method was used to select study participants. The interviews were recorded with consent of study participants. All interviews were transcribed and coded into emergent themes using Nvivo 10 software before thematic content analysis. Results Study participants perceived that the introduction of the SMC intervention in the area had helped to reduce the prevalence of malaria among children less than five years of age. Parents held the view that the drug was very good in preventing malaria. The results also showed high acceptability of the SMC intervention by parents and other community members. Parents reported that they were willing to allow their children to receive the drug and wished the intervention could continue in the district for children to continue to benefit. Nonetheless, negative attitude on the part of few parents made them not to allow their children to receive the drug. Conclusion The interpretation of our data showed high acceptability of the SMC by stakeholders in the study area. However, intensive and continued health education on the benefits of the SMC drug could help to further improve acceptability of the program.

Perception of Malaria Chemoprevention Interventions in Infants and Children in Eight Sub-Saharan African Countries: an End-User Perspective Study

“…The good e cacy and generally favorable safety pro le, as well as the growing experience with this intervention drove the positive perception. Similar ndings have been reported by other researchers, including a recent publication of a qualitative study among parents and CHWs in the upper West region of Ghana which demonstrated that the high acceptability of the SMC intervention was driven by the perception that SMC had helped reduce the prevalence of malaria [20]. The success of SMC at the enduser level could not have been achieved without the early endorsement of the intervention by national stakeholders.…”

“…The consequences of poor adherence to the SMC program can be dramatic as it raises the risk of resistance emergence to the drugs used and impairs the e cacy of the intervention [21]. Although numerous studies tried to estimate adherence to SMC, it must be emphasized that, to date, there is little objective, quantitative data that con rm adherence (such as plasma drug levels) from areas where SMC is implemented as a routine program [20][21][22][23]. In the absence of such a standardized systematic measure of adherence, we investigated the causes for reduced adherence in order to identify measures that could increase access to SMC.…”

“…Work from other groups identi ed further causes for low coverage [22,23] including insu cient training of community distributors, inadequate supply of commodities and insu cient nancial resources for remuneration, advocacy and supervision, and parents forgetting to administer the second and third dose. There were anecdotal mentions of the drug being given to another child, or saved for later, and parental reluctance to allow their children to receive the drug [20,23]. These ndings illustrate the breadth of reasons that can prevent all eligible children from receiving SMC and must be taken into consideration by policy makers and program heads who want to start or optimize SMC in their country.…”

Multilevel modelling of the risk of malaria among children aged under five years in Nigeria

“…The absence of de nite strati cation within this age group suggests that all children under 5 years of age are at high risk. In fact, a seasonal malaria chemoprevention program has been piloted, and shown to signi cantly reduce malaria in under 5 children participating in the mass drug administration program in different areas of diverse malaria transmission intensity (14)(15)(16)(17). Some economic bene t has further been attributed to seasonal malaria chemoprevention of all under 5 children (16,18), with recommendation for this approach to be integrated into the health system in endemic areas.…”

Multilevel modelling of malaria risk in children under five years old in Nigeria

“…shown to signi cantly reduce malaria in under 5 children participating in the mass drug administration program in different areas of diverse malaria transmission intensity (14)(15)(16)(17). Some economic bene t has further been attributed to seasonal malaria chemoprevention of all under 5 children (16,18), with recommendation for this approach to be integrated into the health system in endemic areas.…”