Assessing measles program implementation in Chereponi District, Ghana, 2025

Abstract

Introduction: Measles is a significant public health concern due to its high infection rate, potential for causing severe complications and the impact it has on health systems when it occurs. This study evaluated the measles program in Chereponi District from 2019 to 2024, to assess its strengths, weaknesses, performance indicators, and immunisation coverage. Methods: A mixed-method cross-sectional evaluation was conducted from 2019 to 2024. Performance attributes were assessed using the Centers for Disease Control and Prevention (CDC) surveillance evaluation framework. Data were extracted from District Health Information Management System 2 (DHIMS 2) and Surveillance, Outbreak Response Management and Analysis System (SORMAS) Semi-structured questionnaire was used to interview managers. Quantitative data were summarized in frequency, percentages and graphs using Excel and STATA 17, and qualitative data thematically in NVivo. Results: Of 26 facilities, 22 were CHPS, 2 Health Centers, a District Hospital and DHD. Of 13 managers, 11 were from district level and 2 regional level. Availability of manuals was found as 57.7% (15/26), case definitions as 69.2% (18/26), and case-based forms as 46.2% (12/26) in health facilities. Availability of facility focal persons was 50% (13/26), and 61.5% (8/13) of managers received training in the last two years. Timeliness was 100% (26/26), while funding availability was 26.9% (7/26). About 167 suspected measles cases were reported, with 18.6% (31/167) confirmed. First dose of Measles/rubella coverage peaked at 101.3% in 2020 but declined to 79.6% in 2023. Second dose of Measles/rubella coverage reached 100.6% in 2020 but declined to 84.9% in 2024. In 2024, dropout rate declined to 8.6%. Logistics and transport were the predominant challenge, according to managers, with 92.3% (12/13). Conclusion: The study revealed strengths in case suspicions and reporting timeliness, but weaknesses in stability, logistics and immunisation coverage. The Chereponi Health Management should prioritise surveillance training, improved resource allocation and enhanced vaccination coverage.