Improving experiences of neglected tropical diseases of the skin

Mixed methods formative research for development of a complex intervention in Atwima Mponua District, Ghana

Datos Bibliográficos

ID19593210
AutoresDaniel Okyere (0009-0008-8848-8974, University of Ghana, autor de correspondencia), Edmond Kwaku Ocloo (0009-0008-9185-9756, University of Cape Coast, autor de correspondencia), Lucy Owusu (0000-0002-7241-4187, Kwame Nkrumah University of Science and Technology, autor de correspondencia), Yaw Ampem Amoako (0000-0002-4642-789X, Kwame Nkrumah University of Science and Technology, autor de correspondencia), Ruth Dede Tuwor (Kwame Nkrumah University of Science and Technology, autor de correspondencia), Eric Koka (0000-0002-9683-1444, University of Cape Coast, autor de correspondencia), Jacob Novignon (0000-0002-4718-9328, Kwame Nkrumah University of Science and Technology, autor de correspondencia), Adwoa Asante-Poku (0000-0001-8929-193X, University of Ghana, autor de correspondencia), Ishaque Mintah Siam (University of Ghana, autor de correspondencia), Emmanuel Kyei Afreh, Emmanuel Afreh (0009-0007-1665-7735, University of Ghana, autor de correspondencia), Abigail Agbanyo (0000-0003-3186-4242, Kwame Nkrumah University of Science and Technology, autor de correspondencia), Richard Akuffo (0000-0002-5778-1472, University of Ghana, autor de correspondencia), Solomon Gyabaah (0000-0002-5941-9733, Kwame Nkrumah University of Science and Technology, autor de correspondencia), Michael Ntiamoah Oppong (0000-0001-9482-4438, Kwame Nkrumah University of Science and Technology, autor de correspondencia), Katherine E Halliday (0000-0001-5307-2823, London School of Hygiene & Tropical Medicine, autor de correspondencia), Hope Simpson (0000-0002-2956-5342, London School of Hygiene & Tropical Medicine, autor de correspondencia), Joseph Timothy (0000-0002-6699-0620, London School of Hygiene & Tropical Medicine, autor de correspondencia), Michael Marks (0000-0002-7585-4743, Royal London Hospital, autor de correspondencia), Maria Zuurmond (0000-0002-0347-0126, London School of Hygiene & Tropical Medicine, autor de correspondencia), Shannon L Walker (0000-0002-2034-8376, London School of Hygiene & Tropical Medicine, autor de correspondencia), Rachel L Pullan (0000-0001-9844-1362, London School of Hygiene & Tropical Medicine, autor de correspondencia), Collins Ahorlu (0000-0001-8116-3984, University of Ghana, autor de correspondencia), Collins Stephen Ahorlu, Richard Odame Phillips (0000-0001-8992-0222, Kwame Nkrumah University of Science and Technology, autor de correspondencia), Dorothy Yeboah‐Manu (0000-0002-1663-6287, University of Ghana, autor de correspondencia), Dorothy Yeboah-Manu, Cassady Pitt (0000-0003-4967-8966, University of Ghana, autor de correspondencia), Catherine Pitt, Jennifer J Palmer (0000-0001-7777-722X, London School of Hygiene & Tropical Medicine, autor de correspondencia), SHARP collaboration
EditoresFerdinand C Mukumbang (0000-0003-1441-2172)
Año2024
Volumen4
Número6
Páginase0002833
Fecha de publicación2024-06-13
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaPLOS Global Public Health (JOURNAL)
Identificadores de la revistaISSN: 2767-3375 • E-ISSN: 2767-3375
EditorialPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0002833
PMID38870111
OpenAlexW4399621623
IdiomaEN
Citas recibidas4
Referencias citadas34

Integrated approaches to managing co-endemic neglected tropical diseases (NTDs) of the skin within primary healthcare services are complex and require tailoring to local contexts. We describe formative research in Atwima Mponua District in Ghana’s Ashanti Region designed to inform the development of a sustainable intervention to improve access to skin NTD care. We employed a convergent, parallel, mixed-methods design, collecting data from February 2021 to February 2022. We quantitatively assessed service readiness using a standardised checklist and reviewed outpatient department registers and condition-specific case records in all government health facilities in the district. Alongside a review of policy documents, we conducted 49 interviews and 7 focus group discussions with purposively selected affected persons, caregivers, community members, health workers, and policy-makers to understand skin NTD care-seeking practices and the policy landscape. Outside the district hospital, skin NTD reporting rates in the surveyed facilities were low; supply chains for skin NTD diagnostics, consumables, and medicines had gaps; and health worker knowledge of skin NTDs was limited. Affected people described fragmented care, provided mostly by hospitals (often outside the district) or traditional healers, resulting in challenges obtaining timely diagnosis and treatment and high care-seeking costs. Affected people experienced stigma, although the extent to which stigma influenced care-seeking behaviour was unclear. National actors were more optimistic than district-level actors about local resource availability for skin NTD care and were sceptical of including traditional healers in interventions. Our findings indicate that improvement of the care cascade for affected individuals to reduce the clinical, economic, and psychosocial impact of skin NTDs is likely to require a complementary set of interventions. These findings have informed the design of a strategy to support high-quality, integrated, decentralised care for skin NTDs in Atwima Mponua, which will be assessed through a multidisciplinary evaluation

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