{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:20:50Z","timestamp":1787736050476,"version":"build-2784847793"},"update-to":[{"DOI":"10.1371\/journal.pntd.0010805","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000}}],"reference-count":14,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T00:00:00Z","timestamp":1686528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"USAID","award":["7200AA18CA00011"],"award-info":[{"award-number":["7200AA18CA00011"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background and methodology<\/jats:title>\n<jats:p>In districts where lymphatic filariasis (LF) is endemic, the goal is to provide 100% geographical coverage of the essential package of care. Additionally, countries seeking elimination status must document the availability of services for lymphoedema and hydrocele in all endemic areas. To do this, the WHO recommends conducting assessments of the readiness and quality of services provided to identify service delivery and quality gaps. This study used the recommended WHO Direct Inspection Protocol (DIP), which consists of 14 core indicators related to LF case management, medicine and commodities, staff knowledge and patient tracking. The survey was administered in 156 health facilities across Ghana designated and trained to provide LF morbidity management services. Patient and health provider interviews were also conducted to assess challenges and feedback.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Principal findings<\/jats:title>\n<jats:p>The highest performing indicators across the 156 surveyed facilities were related to staff knowledge; 96.6% of health workers correctly identified two or more signs and symptoms. The lowest scoring indicators concerned medication availability, with the two lowest scoring indicators in the survey being availability of antifungals (26.28%) and antiseptics (31.41%). Hospitals performed best with an overall score of 79.9%, followed by health centers (73%), clinics (67.1%) and CHPS compounds (66.8%). The most commonly reported challenge from health worker interviews was lack of medications and supplies, followed by a lack of training or poor motivation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions and significance<\/jats:title>\n<jats:p>The findings from this study can help the Ghana NTD Program identify areas of improvement as they seek to achieve LF elimination targets and continue to improve access to care for those with LF-related morbidity as part of overall health systems strengthening. Key recommendations include prioritizing refresher and MMDP training for health workers, ensuring reliable patient tracking systems, and integrating lymphatic filariasis morbidity management into the routine healthcare system to ensure medicine and commodity availably.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0010805","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T17:33:39Z","timestamp":1686591219000},"page":"e0010805","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluating the availability and quality of services for lymphatic filariasis morbidity in Ghana"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2520-220X","authenticated-orcid":true,"given":"Melissa","family":"Edmiston","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solomon","family":"Atinbire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest O","family":"Mensah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"Mensah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bright","family":"Alomatu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kofi","family":"Asemanyi Mensah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Palmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,6,12]]},"reference":[{"key":"pntd.0010805.ref001","unstructured":"Lymphatic filariasis: managing morbidity and preventing disability: an aide-m\u00e9moire for national programme managers, 2nd ed. [Internet]. [cited 2022 May 20]. https:\/\/www.who.int\/publications-detail-redirect\/lymphatic-filariasis-managing-morbidity-and-preventing-disability-an-aide-m\u00e9moire-for-national-programme-managers-2nd-ed."},{"key":"pntd.0010805.ref002","unstructured":"Lymphatic filariasis [Internet]. [cited 2022 May 20]. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/lymphatic-filariasis."},{"issue":"2","key":"pntd.0010805.ref003","first-page":"301","article-title":"A preliminary study of filariasis related acute adenolymphangitis with special reference to precipitating factors and treatment modalities","volume":"26","author":"RK Shenoy","year":"1995","journal-title":"Southeast Asian J Trop Med Public Health"},{"issue":"12","key":"pntd.0010805.ref004","doi-asserted-by":"crossref","first-page":"2561","DOI":"10.1093\/cid\/ciz671","article-title":"The Health and Economic Burdens of Lymphatic Filariasis Prior to Mass Drug Administration Programs","volume":"70","author":"CG Mathew","year":"2020","journal-title":"Clin Infect Dis"},{"key":"pntd.0010805.ref005","unstructured":"A Cohort Study of Lymphatic Filariasis on Socio Economic Conditions in Andhra Pradesh, India | PLOS ONE [Internet]. [cited 2022 May 20]. https:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0033779."},{"issue":"1","key":"pntd.0010805.ref006","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s13071-020-3996-4","article-title":"Demographic, socioeconomic and disease knowledge factors, but not population mobility, associated with lymphatic filariasis infection in adult workers in American Samoa in 2014","volume":"13","author":"PM Graves","year":"2020","journal-title":"Parasites & Vectors"},{"key":"pntd.0010805.ref007","unstructured":"Global programme to eliminate lymphatic filariasis: progress report, 2020 [Internet]. [cited 2022 May 20]. https:\/\/www.who.int\/publications-detail-redirect\/who-wer9641-497-508."},{"issue":"12","key":"pntd.0010805.ref008","doi-asserted-by":"crossref","first-page":"e3328","DOI":"10.1371\/journal.pntd.0003328","article-title":"Global Programme to Eliminate Lymphatic Filariasis: The Processes Underlying Programme Success","volume":"8","author":"K Ichimori","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010805.ref009","unstructured":"Ending the neglect to attain the Sustainable Development Goals: A road map for neglected tropical diseases 2021\u20132030 [Internet]. [cited 2022 May 20]. https:\/\/www.who.int\/publications-detail-redirect\/9789240010352."},{"key":"pntd.0010805.ref010","unstructured":"World Health Organization. Validation of elimination of lymphatic filariasis as a public health problem [Internet]. World Health Organization; 2017 [cited 2022 May 20]. https:\/\/apps.who.int\/iris\/handle\/10665\/254377."},{"key":"pntd.0010805.ref011","unstructured":"USAID\/FHI 360. Act to End NTDs | West Ghana FY22 Annual Workplan [Internet]. https:\/\/www.actntdswest.org\/sites\/default\/files\/inline-files\/Act%20West%20FY22%20Workplan-Ghana.pdf"},{"key":"pntd.0010805.ref012","unstructured":"WHO. Protocol for evaluating minimum package of care of morbidity management and disability prevention for lymphodema management in designated health facilities. [Internet]. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/339870\/9789240017085-eng.pdf."},{"key":"pntd.0010805.ref013","unstructured":"WHO\/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) | UN_Water [Internet]. UN-Water. 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