In Ghana, IRS is a core vector control intervention and a component of the current National Malaria Control Strategy and Ghana Strategic Plan for Malaria Control 2014-2020. PMI support for IRS started in 2008. In the ensuing 12 years, PMI has targeted between five and nine districts in the Northern region (recently divided into three regions: Northern, North East, and Savannah) per year, with the highest number of structures sprayed (383,142 structures) and population protected (941,240 people) in 2012. AngloGold Ashanti Malaria Control Ltd (AGAMal) has been conducting IRS since 2006 in the Obuasi district of the Ashanti region with its own funds. Since 2008, AGAMal has received financial support from the Global Fund to expand its IRS activities to the entire Upper West and three districts in the Upper East regions.
In the last five years of implementing IRS, PMI has targeted between five and nine districts in the Northern region (recently divided into three regions: Northern, North East, and Savannah) per year, with the highest number of population protected (965,467 people) in 2020. Another large IRS implementer is AngloGold Ashanti Malaria Control Ltd (AGAMal), which has been conducting IRS since 2006 in Obuasi district of Ashanti region with its own funds. Since 2008, AGAMal has received financial support from the Global Fund to expand its IRS activities to the entire Upper West and three districts in Upper East regions.
In 2020, the PMI VectorLink Ghana project conducted IRS in nine districts, targeting 346,285 structures using Actellic (pirimiphos-methyl), Fludora Fusion (clothianidin and deltamethrin), and SumiShield (clothianidin) insecticides, from March 24 to April 28, 2020. A total of 339,139 structures were sprayed out of 366,283 structures that spray operators (SOPs) found in the targeted districts, accounting for a coverage rate of 92.6%. In 2020, VectorLink Ghana expanded IRS to Tatale-Sanguli district (TSD) bringing the total of PMI IRS districts to nine. The project also sprayed 6,219 eligible animal shelters in five districts based on data on resting and feeding behaviors collected in previous years to improve vector control.
To date, the project has supported NMCP with entomological surveillance including annual insecticide resistance monitoring and monthly vector bionomics monitoring at established sites within PMI IRS districts. The project has also supported National Insecticides Resistance Monitoring Partnership (NIRMOP) through a subcontract to Noguchi Memorial Institute for Medical Research (NMIMR), which collected and reported on insecticide resistance data in 20 established sentinel sites throughout the country. In addition, the project regularly monitored spray quality and residual efficacy of IRS insecticides.
Since mid-2019, VectorLink Ghana has been implementing ITN technical assistance activities following the VectorWorks project close-out. Major activities completed to date are 12- and 24-month ITN durability monitoring data collections, inclusion of ITN-related questions in the NMCP’s outreach training and supportive supervision (OTSS+), and technical support to the Ghana Health Service’s (GHS’s) integrated supportive supervision (ISS); local partner engagement to develop and implement social behavior change (SBC) activities to boost net usage among health care providers and pregnant women; regular data review of ITN distribution through health facilities; and initiation of a mentorship program between low- and high-performing districts. In addition, the project co-designed a pilot to test ITN distribution mobile application, led monthly planning sessions with the NMCP vector control team, and co-facilitated trainings for and supervised the 2020 school-based distribution campaign.
In its fourth year (2021), VectorLink Ghana will conduct IRS in nine districts: Bunkpurugu-Nakpanduri (BND), East Mamprusi (EMD), Gushegu (GUD), Karaga (KAD), Kumbungu (KUD), Mamprugu Moaduri (MMD), Tatale-Sanguli (TSD), West Mamprusi (WMD), and Yunyoo-Nasuan (YND), from on/about March 23 through May 5, 2021.
For IRS, the PMI VectorLink Ghana project will work with the NMCP, GHS Regional and District Health Directorates, District Assemblies, and community and religious leaders to spray 366,283 targeted structures in nine districts using SumiShield (in BND, EMD, GUD, and YND), and Fludora Fusion (in KAD, KUD, MMD, TSD, and WMD). The project’s primary objective is to reach a minimum coverage of 85% of the structures found in each district by implementing high-quality IRS operations (and at least 90% of eligible structures per the NMCP target).
In addition to spraying, in 2021, the project will carry out the following activities:
- Expand mobile data collection in all IRS districts following the successful pilot in TSD and two operations sites in GUD.
- Continue to use VectorLink Collect in Ghana to manage IRS and entomology data.
- Conduct monthly vector bionomics monitoring in 12 sentinel sites nationwide including 6 in PMI-supported IRS districts, 2 non-sprayed sites and 4 newly established sites for the national entomology surveillance program.
- Monitor insecticide resistance in 13 sites (10 PMI IRS, 3 non-sprayed)
- Provide technical support for strategic decision making and deployment of interventions for malaria control to the Malaria Vector Control Oversight Committee (MaVCOC).
- Continue skill transfer to the GHS at all levels on vector control to ensure proper monitoring, implementation, and sustainability of IRS.
- Continue supporting NIRMOP to collect annual insecticide resistance data at 15 sentinel sites.
- Monitor the residual efficacy of two insecticide formulations that will be sprayed in 2021.
- Continue providing technical support to the NMCP with monitoring routine distribution of ITNs.
- Support planning and execution of the 2021 ITN point mass distribution campaign.
- Complete the durability monitoring study by conducting 36-month data collection and analysis.
- Expand implementation of SBC activities to boost ITN use in eight additional districts, bringing the total to 13 districts in Central region.
Click here to see how PMI VectorLink Ghana recycles and repurposes materials from their indoor residual spraying campaign.