Wednesday, November 24, 2010
Thursday, August 19, 2010
As part of TAMTAM’s operational research, we are again testing the impact of using community health volunteers to hang mosquito nets for households on net usage. At the same time, we are also observing the rate at which households will install nets on their own and whether or not the nets make it home after a fixed point distribution. These questions were all suggested by malaria policymakers in Ghana. We hope to deliver useful findings for them through our work these past few months.
The community health workers are now visiting homes to install mosquito nets and collect other information. They have been trained to hang nets in different types of rooms, over beds and mats, and armed with supplies such as flashlights, nails, and hammers.
We look forward to hearing that households not only own but also use their mosquito nets to cover their entire family.
Monday, August 9, 2010
After two action-packed days, nearly 2000 nets have been distributed for free to communities in Dzamam sub-district. Five separate distributions were supported by the community health volunteers, the local health clinic, KLO Drivers’ Alliance, and the TAMTAM team. The tro-tro van which carried our 2,000 nets and team members traveled many kilometers over challenging terrain to reach the communities. The distributions occurred at central community hubs: a health clinic, two churches, and two schools. Each distribution began with a malaria message to the gathered community by Mr. Sackitey Offei, the leader of KLO. The message covered basic malaria prevention information and proper care (mild soap, no sun exposure, minimal washing) and use of the mosquito nets including a hang-up demonstration. Following the message, household heads were called by name from the pre-registration list and given the mosquito nets allocated to their household. TAMTAM’s mosquito nets, WHO-certified Permanets manufactured by Vestergaard-Frandsen, were prepared by opening the package and cutting a hole in the tag to mark TAMTAM nets. Hooks, strings, and an instructional cartoon were included in the distributed packs. Nets were opened to ensure they could not be sold and so that households were know to use the nets immediately instead of saving them for the future. It was quite an assembly line with all hands on deck to assemble thousands of nets for distribution.
At the end of the distributions, we were satisfied to know that six communities, or 3,700 people in 585 households were protected by TAMTAM mosquito nets. It was especially rewarding to see mothers and small children and pregnant women taking home nets. Thank you to KLO Drivers Alliance for their preparation and facilitation of the entire project. The staff members of the Dzamam health clinic (Barbara, Wahab, Eudia, and Abigail) have been very helpful- from shuttling us to distant villages on their Ghana Health Service motor bikes, coordinating collection of data from volunteers, and storing our supplies. They are all nurses and technicians assigned to this rural site, far from their homes and where they must learn the new language of Krobo. Once again, we have been inspired by local partners and found their participation critical to the success of our work.
Sunday, August 8, 2010
Dzamam is a sub-district of Upper Manya Krobo District. The district was formed just two years ago, after Manya Krobo became too large to adequately distribute resources. The new district is working to develop its own systems and leadership. Its capital is Asesewa, which is about one hour by car from the Eastern Region capital of Koforidua. Dzamam consists of sub-districts and communities which are largely farmers of cassava, maize, and cocoa yam. There are also fishing villages since the Volta River and its tributaries are in the area. Market day is Friday in Asesewa (mini-market on Monday) so that is the busiest transport day- with tro-tros and cars kicking up heaps of dust on the usually quiet roads. It has been a pleasure to get to know this area- with rich soil, lush green mountains during this rainy season, and welcoming people. The useful phrase, “Mo choom ka” or “Thank you very much” in the local Krobo language, has served us well.
Wednesday, July 28, 2010
In Accra, the TAMTAM team benefited from the input and expertise of the Ghana National Malaria Control Program, USAID’s malaria control team, and ProMPT (Promoting Malaria Prevention and Treatment), among others. Their insights into current and future malaria activities and learning from past initiatives have greatly informed TAMTAM’s study.
In the context of a point distribution, TAMTAM’s study will examine the rates of net self-installation and leakage over time, as well as the impact on usage of using community health volunteers to hang nets in homes. To support the plans of Ghana’s National Malaria Control Program, our study will be located in the Eastern Region, which is a high priority region list for large-scale mosquito net distributions to achieve full coverage. We are collaborating with one of ProMPT’s local partners, KLO Drivers Alliance based in Asesewa, close to the capital of Eastern Region, called Koforidua. KLO has been working locally on health initiatives for a decade and has networks of volunteers throughout the many communities it serves. Originally, KLO focused on connecting with taxi and public transport drivers as a means to combat the spread of HIV/AIDS. Here is Mr. Sackitey Offei, director of KLO signing an MOU with TAMTAM.
KLO works hand-in-hand with a local health clinic in the sub-district of Dzamam, which will be the base for TAMTAM’s field activities. Located on a quiet dirt road, the clinic employs 4 staff and acts as a hub for the community health volunteers and health initiatives. We have been pleased to meet the committed and capable staff and found their guidance critical to arranging local plans.
We have submitted our tome of documents (above) to the Ghana Health Service Ethics Review Committee for IRB approval. We have identified 7 community health volunteers for our project – at least one for each of the communities we will cover with mosquito nets: Dzamam, Dawatrim, Brepaw, Afuafie, Adwenso, and Takorase. These volunteers will be our hands and feet in the villages where they will collect assess household sizes and population counts, assist in the distribution of mosquito nets and complete follow-up activities such as hang-up and monitoring.
The TAMTAM team is looking forward to putting mosquito nets over at-risk populations very shortly! Many thanks for all the emails and generous support that have come to us here in the field.
Wednesday, July 7, 2010
We have been working hard to go with VHTs on home visits as often as possible to ensure data quality and consistency. The VHTs have done a great job, and it has been very informative for us to be able to see challenges as they occur and fix them in real time. The VHTs are doing one last large push today and tomorrow to finish up the survey and then the collection will be wrapped up in Ntenjeru.
We also spent three days in Kampala meeting with individuals leading governmental and international malaria research and action organizations. We got up-to-date on the current efforts across all the different organizations in Uganda and established connections with individuals leading national research programs. There is currently a nationwide distribution of nets to pregnant women and children under five. After this category of people is covered, the government will then do a “top up” to distribute one net for every two people in every household. We were excited to learn that our results should be ready in time to inform the procedural development for this “top up” distribution. In August, we will be meeting with some of the organizations coordinating this to share our findings and recommendations.
Finally, we have started to plan the follow-up in Gulu. After meeting with our on-the-ground coordinator there, we have been working out the details of the budget and follow-up activities. We look forward to getting started on the training next week.
Tuesday, June 22, 2010
Hummy checking up on a TAMTAM net in a local household
We were also excited to learn that, thanks to the efforts of the VHTs and government educational programs, the majority of net recipients correctly identify how an individual contracts malaria. Understanding how malaria is contracted, and therefore why bed nets are important, should also help increase correct utilization of the nets.
We are now back in Ntenjeru where we will spend the week continuing to shadow the VHTs on home visits as well as working with the health clinic’s records to get a better understanding of how the number of diagnosed malaria cases have changed over the course of the year. We are hoping that with additional layers of data we will be able to look at the impact of net distributions on diagnosed malaria cases.
Monday, June 14, 2010
Thursday, June 10, 2010
The Uganda TAMTAM has arrived on site in Ntenjeru and hit the ground running! This year’s team consists of Sheryl, who is working on her Master of Science in Epidemiology at the Harvard School of Public Health, Hummy, who is working on her Master in Public Policy at the Harvard Kennedy School of Government, and Laura who just completed her Master’s of Business Administration.
This summer, the team is focused on collecting follow-up data on the 400+ home bed nets that were distributed to last year. The nets were given out through different techniques and the team will evaluate the follow up data to see if techniques resulted in increased utilization. This information will be reported to the government, US health organizations, and other NGOs to improve the methods through which nets are distributed in the future.
We arrived in Uganda on Saturday and after a bumpy ride down to the Volset Foundation's White House we were treated to a delicious dinner by the wonderful women working at the House. On Sunday, we spent the day learning how to do basic tasks, like washing dishes and bathing, without the luxuries of home life and also had the chance to have some fun with the kids that live nearby.
Monday we got right to work going to the Volset Office to meet with two of the Volunteer Health Team members (VHTs) to develop the follow-up survey, schedule dates for training all of the VHTs, and work on training materials. We’ll spend the rest of this week working closely with the VHTs as well as people involved in the initial follow up study last September, to develop the follow-up survey and the training which we will be giving to the VHTs next Tuesday.
We have been warmly welcomed by the community, kids, and VHTs. We’ve been inspired by many of the leaders of the community that we’ve had the pleasure to meet and all the fantastic work they’re doing to improve education, healthcare, community services, and support for the HIV+ community. We’re really excited to be starting off a great summer of working for TAMTAM in Ntenjeru!