Knowledge of malaria transmission low, prevention and treatment options limited.
25th January 2012, Accra, Ghana– Volunteer Partnerships for West Africa has released the results from its most recent case study, Knowledge, Treatment and Prevention of Malaria in Rural Ghana: A Case Study of Darmang.
The study was conducted from May to July 2011 in the village of Darmang Anhuntem, located in the Akuapim South Municipality of the Eastern Region of Ghana. The objective of the study was “to assess the effectiveness of anti-vector interventions taken by the National Malaria Control Program (NMCP), as well as availability of treatment and means of protection in rural communities.” A series of qualitative interviews with local people in Darmang revealed limited knowledge about malaria transmission and symptoms, lack of affordable protection options, and financially and geographically inaccessible treatment for the disease within the community.
Misconceptions about malaria transmission are still widely prevalent in Darmang. According to the report while “[m]ost of the respondents (92%) knew that malaria is caused by mosquitoes…. more than half (52%) of the respondents gave additional sources for the disease which included working close to a heat source like fire or in the sun, eating too much oil or starch, contaminated houseflies on food, cold temperatures or airborne particles.” When asked about malaria symptoms, “More than half felt that malaria and fever is the same thing,” including one of three local chemists whom was interviewed.
When asked about first response to a suspected malaria infection “more than two thirds of the respondents reported not seeking hospital care for treatment of malaria due to lack of financial means and geographical access.” An overwhelming 73% of respondents said they would self-medicate with traditional herbs or over-the-counter drugs . Meanwhile, only 17% of respondents would go to a hospital.
However, “Despite the low numbers seeking first response treatment at a hospital, when asked the majority of the respondents (64%) believed that being diagnosed and receiving care at a hospital is the best way to treat malaria. Reasons for not seeking such care were in all cases financial reasons; the main obstacle being a lack of financial means to pay for, diagnose and receive treatment by a doctor at the hospital, as well as buying the prescription medications.”
Even the 17% of respondents who had national health insurance (NHS) said that they sometimes opted out of going to the hospital due to inconvenient location and the cost of transportation to the healthcare facility. They instead opted for easily accessed herbs and drugs at a local drugstore.
The awareness and existence of malaria protection options in Darmang is also very limited. Most respondents initially cited bush clearing, cleaning, and taking preventative drugs as primary methods in effectively preventing malaria. Using an Insecticide Treated mosquito Net (ITN) was secondary. While the “majority of the respondents (68%) owned at least one net…. [only] 22 % of the respondents who owned a net cited that every member in their family slept under one” due to financial circumstances and lack of ITN availability. Although, the respondents recognize and utilize ITNs as an effective malaria protection measure, only half of the respondents had ever heard of but never seen Indoor Residual Spraying (IRS). Anti-vector strategies to control malaria are not readily available to them.
“[T]here is a considerable lack of knowledge regarding malaria,” the report concludes. Misconceptions about malaria transmission greatly impede anti-vector strategies and prevention of malaria in a community.
The study highlights that mosquitoes adapt and change their behavior “according to geographic location, dry or wet season and human behavior e.g. sleeping outside or use of insecticides,” and therefore, the government should fund further research on alternative anti-vector control measures for reducing malaria.
“However as long as this free health care remains inaccessible to the majority of the citizens of Ghana, especially to the poorest who need it the most, it is inherently meaningless. Lacking the ability to pay annual premiums, poor people in Ghana are indirectly being excluded from the public health care…” Most importantly, the report highlights the plight of Ghana’s poor citizens and calls upon government to make malaria elimination a national priority through universal healthcare. It proposes “dedicated political support and financial reconsiderations” as key to eliminating malaria. The Darmang community and its limited knowledge and options in coping with the threat of malaria, speaks for a greater whole of rural Ghana.
In Ghana, one out of every ten children will die before reaching the age of five and malaria is still the number one cause of these deaths.