Towards malaria control and elimination in Ghana: challenges and decision making tools to guide planning

Abstract

Ghana is classified as being in the malaria control phase, according to the global malaria elimination program. With many years of policy development and control interventions, malaria specific mortality among children less than 5 years old has declined from 14.4% in 2000 to 0.6% in 2012. However, the same level of success has not been achieved with malaria morbidity. The recently adopted 2015–2020 Ghana strategic action plan aims to reduce the burden of malaria by 75.0%. Planning and policy development has always been guided by evidence from field studies, and mathematical models that are able to investigate malaria transmission dynamics have not played a significant role in supporting policy development. The objectives of this study are to describe the malaria situation in Ghana and give a brief account of how mathematical modelling techniques could support a more informed malaria control effort in the Ghanaian context. A review is carried out of some mathematical models investigating the dynamics of malaria transmission in sub-Saharan African countries, including Ghana. The applications of these models are then discussed, considering the gaps that still remain in Ghana for which further mathematical model development could be supportive. Because of the collaborative approach adopted in their development, some model examples Ghana could benefit from are also discussed. Collaboration between malaria control experts and modellers will allow for more appropriate mathematical models to be developed. Packaging these models with user-friendly interfaces and making them available at various levels of malaria control management could help provide the decision making tools needed for planning and a platform for monitoring and evaluation of interventions in Ghana.

Applied mathematical modelling to inform national malaria policies, strategies and operations in Tanzania

“…Mathematical models have been applied for various countries at varying resolutions, examples include sub-Saharan African (SSA) countries [15,[20][21][22], Ghana [23,24], Kenya [25,26], Mozambique [27,28], Nigeria [16,17,29], Uganda [30], South Africa [31], Zambia [32][33][34][35], and the Asia-Pacific Region [36,37]. In those examples, modelling was used to investigate relevant transmission dynamics, intervention effectiveness or for stratification.…”

“…While sometimes useful for global policy writing, there have been fewer examples where mathematical modelling has been applied in a country at the required operational unit and accompanied with a national policy dialogue. Exceptions are Zambia [35], Ghana [24], South Africa [31], Cambodia and Thailand (Mahidol Oxford Research Unit (MORU)), Mozambique, Sri Lanka, Phillippines, Benin (Swiss Tropical and Public Health (Swiss TPH)). In Kenya, Tanzania and Uganda, a decision support tool has been developed in communication with local stakeholders, to link research and policy for "guiding the selection of more effective, evidence-based control strategies" [14,38]; however, no country-wide application could be found.…”

Accounting for regional transmission variability and the impact of malaria control interventions in Ghana: A population level mathematical modelling approach

“…Although these interventions are in place, evaluating their effectiveness using mechanistic models based on locally available data still remains largely unexplored [6]. Despite the contributions of earlier developed mathematical models, describing the transmission dynamics of malaria in the country, there still exist important knowlegd gaps in determining a rational basis for deploying these interventions and evaluating them in the three different ecological zones of Ghana [7].…”

“…The objective of this paper is to develop a mathematical model to project the impact of various intervention scenarios of malaria intervention control programs in Ghana, simulated at a sub-population level that represents the three main ecological zones [7]. The impact of various levels of usage and protective effectiveness as well as coverage of LLINs and IRS are also investigated and prospects of achieving relevant locally and internationally set goals of malaria control and elimination in Ghana are considered.…”

Verifying the impact of corporate governance on hospital performance on HIV and malaria control: A structural equation modelling approach

“…In 2016, the country recorded approximately 10.4 million suspected malaria cases representing about 39% of all OPD cases seen, which is alarming. Awine, Malm, Bart‐Plange, and Silal asserted that through the National Malaria Control Programme (NMCP), Ghana is now implementing 2015‐2020 strategic action plan that aims towards reducing death and illness due to the malaria disease by 75%. This strategy is to be accomplished through overall health sector development, enhanced strategic investments in malaria control, and improved coverage towards universal access to malaria treatment and prevention interventions, so as to control the deadly disease.…”