Assessment Of The Implementation Of Indoor Residual Spraying In East Mamprusi District

ABSTRACT Malaria is highly endemic in the Northern part of Ghana with seasonal variabilities in the cases of malaria reporting. The highest numbers of cases are reported during the rainy season. IRS can contribute to the elimination of malaria if rigorously applied (World malaria report, 2013). Every year, since indoor residual spraying implementation in the East Mamprusi district there has been spraying exercises conducted between April and May. This period falls within the rainy season when the cases of malaria peak. For the last three years from 2015- 2018 high reported coverage of indoor residual spraying has been achieved in the district. In 2015 over 60283 structures were sprayed representing 91.2% of spray coverage, protecting 94.6% of the population in the East Mamprusi district. However, in 2018 the coverage was lower compared with the previous years. About 64611 households were sprayed with a coverage of 89.8%. Over 93.4 % of the population were protected, 2.1% and 13.9% constituting pregnant women and children under five years respectively( Ghana End of spray report, 2018) The success of an indoor residual spraying (IRS) campaign can be impacted by several individual, household and health system factors. These factors collectively or single handily can affect the implementation process. The objective of this study was to conduct a process evaluation of the indoor residual spraying exercises in the East Mamprusi district. Method This was a descriptive cross sectional study that used both quantitative and qualitative methods to evaluate the implementation process of indoor residual spraying in the district. The study was conducted in the East Mamprusi with 427 respondents. Collection of data was done between June and July using structured questionnaires. Descriptive statistics such as means, charts, tables and proportions was used to summarize the data. Chi square test of v association was used to explore the relationship between the factors affecting IRS implementation in the district. Multiple logistic regression was also used to determine the factors affecting IRS implementation. The Qualitative data was collected using Focus Group discussions (FGD), In-depth interviews and document reviews. The transcripts were imported into Nvivo version 12 and coding of thematic areas was done. The data was then analyzed using thematic analysis and the findings from this qualitative data was triangulated with the findings of the quantitative data. Results: The results indicated that 390 respondents representing 91.8% of household heads reported that their houses were sprayed with indoor residual spraying during the last six months. For indoor residual spraying activities, 1 week of training was organized for the spray operators and supervisors while 1 day training for mobilizers. Communities were sensitized through the radio/FM and traditional gongong beating. Factors associated with indoor residual spraying coverage were Ethnicity, insecticide treated nets ownership and age ranged 58-68 (Odd ratio 0.112, P value 0.05, Confidence interval 0.012, 1.002) Conclusion: The indoor residual spraying coverage for the East Mamprusi District for the 2019 spray round was 91.8% which is one percentage point slightly higher than the coverage obtained for 2018 (89.8%. ) This is higher the WHO 80% spray target for indoor residual spraying to be effective against malaria. There is the need to sustain this level of coverage through achieving the targets set for each activity for indoor residual spraying exercise in the district.