Ghana malaria prevention programme, Annual Review

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The Health and Education Advice and Resource Team (HEART) was contracted to undertake the first Annual Programme Review (APR) of the DFID-funded Ghana Malaria Prevention, Diagnosis and Data Programme. This review was undertaken between 24 July and 20 August 2014 by a team of two external consultants. The Review Terms of Reference (TOR) posed questions relating to progress in implementing the project since it commenced in August 2013. The review was carried out primarily through a secondary analysis of project reports and other relevant documents, supplemented by key stakeholder interviews both in Accra and during a field trip to Central Region.

The components for this project are:

  • Procurement of long lasting insecticidal nets (LLIN) for routine distribution under the continuous distribution strategy
  • Social marketing of LLIN
  • Seasonal Malaria Chemoprevention (SMC) trial in Northern Region
  • Provision of rapid diagnostic tests (RDTs) for the private health sector
  • To increase use of LLINs
  • To increase uptake of RDTs
  • Improving data with Malaria sentinel sites and recruitment of an epidemiologist
  • Enhancing finance with support to the National Malaria Control Programme (NMCP) resource mobilisation officer

 

Impact:

  • Reported mortality attributed due to malaria, for both the under-five population and the general population – two of the project impact indicators – fell in both 2012 and 2013 from the programme’s baseline figures. If this trend continues, these programme milestones and targets should be achieved by the end of the programme.
  • The third impact indicator, ‘the proportion of children under five admitted with fever attributed to malaria’, is not behaving in the anticipated way and is rising. This is likely to be a result of external complicating factors. It is recommended that this indicator be reviewed.

 

Lessons learned:

  • The three programme components involving the procurement of malaria commodities worked well and evaluators learned that the Ministry of Health procurement system has the capacity to undertake such significant procurements. For the other components, the time required to tender and contract the implementing organisations has taken around six months and so there was only limited time available for implementation in the first year.
  • Government of Ghana financial systems have taken much longer than anticipated to transfer funds for several components’ activities to the NMCP. This has resulted in some activities not having yet started.
  • The programme procured the SMC drugs for Output 2 (Delivery of four doses of SMC per year to 556,000 children in Northern Region) but implementation was to be funded from another source. This did not eventuate. It is not clear that due consideration was given to this risk in project preparation.
  • One of the programme’s impact indicators and one outcome indicator have been affected by developments external to the project, and so they are not performing as anticipated.
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