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I’m working on a PowerPoint on Malaria and Under-5 Mortality in Northern Ghana. I’m having trouble with finding the data on effect size of task shifting on page 3 which can fill into page 7 for strategy. Please make some explanation and list all the references.
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Addressing the Burden of
Malaria as the leading cause
of Under-Five Mortality in
Northern Ghana
$613,769
Over 5 years
Your Commitment for 5 Years Can Deliver Life-Saving Long Lasting Insecticide-Treated Nets against Malaria to
> 52,946 each year Children under Five in Northern Ghana, Potentially Preventing 400 Deaths per 1000 Live Births.
Audience:
Burden of the disease: Malaria and Under-5 Mortality
in Northern Ghana
• In 2021, WHO reported 5.3 million malaria cases
Figure 1: Key Disparities in Under-Five Mortality Rate in Ghana
in Ghana, causing approximately 12,500 deaths
(WHO, 2022).
• Northern Ghana reports the highest
malaria-related mortality rate at 9 per 1000 live
births compared to the national average of 6.
• In 2017, U5M rates due to malaria were highest in
Northern Ghana (118), followed by Upper West
(98) and Ashanti (85) (EQUIST; UNICEF).
• Limited healthcare infrastructure, coupled with
geographical inequities, poverty, and limited
healthcare access, impedes effective malaria
interventions, leading to higher mortality rates in
Northern Ghana.
Figure 1 shows Rural areas and the poorest category experience higher U5M rates,
with 80 deaths per 1000 live births and 89 deaths per 1000 live births, respectively.
Source: EQUIST (UNICEF).
Burden of the disease: Malaria and Under-5 Mortality
in Northern Ghana
•
•
Figure 2 shows that Northern Ghana reports the highest malaria-related mortality rate at 9 per 1000
live births compared to the national average of 6.
Figure 3 is a bubble map showing that Northern Ghana has fewer and more dispersed healthcare
facilities compared to densely equipped regions like Ashanti (EQUIST bubble map; UNICEF).
Figure 2: U5M Rates Due to Malaria by Region in Ghana Relative to National Average
Figure 3: healthcare facilities across Ghana
ITNs: An Effective Malaria Prevention Strategy
Long-lasting Insecticide Treated Bed Nets (ITN)
•
ITNs have proven to be an effective and feasible strategy
against malaria infections, either used alone or in
combination with Indoor Residual Spraying (IRS)
(Komazawa et al., 2012).
•
ITN Usage in Ghana: Only 54% of children under five in
Ghana sleep under ITNs (GSS, 2019).
•
Afoakwah et al. demonstrated that utilizing ITNs can
reduce approximately 18.8% of Under-5 Mortality (U5M)
malaria-related cases in Northern Ghana (2015).
•
Feasible and cost-effective: The median financial cost per
ITN is estimated at $7.03 (range $2.97-$19.20) (White et
al., 2011).
Figure 3: Save 1000 children at risk from malaria in Ghana
Source: Hopes Care International.
•
Implementing ITNs in Northern Ghana could potentially
prevent 43.2 deaths per 1000 live births, compared to the
least deprived population rate of 31 (EQUIST data).
Addressing Bottlenecks to Achieving Effective ITN
Coverage in Northern Ghana
•
Financial constraints (38.18%), limited availability of human resources (0.668 workers per 1,000
population), and sociocultural acceptability (48.43%) pose critical bottlenecks hindering ITN
coverage for children under five in Northern Ghana (Herbst et al., 2011).
Figure 5: Frequency of bottlenecks to effective coverage of ITNs in children under 5 experiencing malaria in Northern Ghana, identified by the
Takahashi model (EQUIST; UNICEF)
Strategies for effective ITN coverage: Multi-approach program
combining free distribution, task shifting, and community education
Bottleneck
Strategy
Effect size
Evidence
Financial affordability
Free distribution of ITNS
through health insurance
Up to 53%
65.5% coverage resulted in a utilization rate of 75.6%, with
rural areas showing a 44% higher coverage compared to
their urban counterparts
(Afagbedzi et al., 2023; EQUIST; Kanmiki et al., 2019)
Availability of human
resources
Incentivizing already trained
workers through task shifting
Sociocultural
acceptability
Community education
outreach
•
•
Up to 80%
Meta-analysis in sub-Saharan Africa, 2021
Integrated Approach: distribution through community programs such as expanded immunization programs
Program Optimization: Collaboration with local NGOS and existing community programs
Cost-Effectiveness Analysis of ITN Intervention in Northern Ghana
Cost Component
Estimated value
Method of calculation
Evidence
Population in Need
(Children under 5)
52,946
% of children (0-14 years) = 10,890,453 in Ghana
assume that the distribution is equal across the age
groups
then children under 5= 14%
0.14*374,744 (otal in northern ghana)=52,946
GSS 2021
Current effective coverage
Target effective coverage
Scale up
43%
80%
80-43%=37%
EQUIST
EQUIST
rate of utilization
43%
EQUIST
EQUIST
additional contingency cost
(30%)
$1.287
Literature-based
White 2011
Economic cost per person
(direct and indirect healthcost)
$1.43
Literature-based
Scade 2022
Economic cost per treated net
year (cost associated w
$2.86
Literature-based
Scade 2022
$4.45 (USD)
Literature-based
UNICEF LLIN Market
implementation and
maintenance of bed net
programs and economic
impact of preventing
malaria)
Total Cost per ITN (including
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