Defaulter Tracing Can be Successful: The experience of the Disease Surveillance Department with Prayer Camps in the Ningo Prampram District Angmortey I1, Bonful HA1, Dwamena E2, Okpodjah V2, Ofori Ansah G1 1 Ningo Prampram District Health Administration 2 Old Ningo Health Center

Presentation Outline Background Issues Description Lessons learnt Next Steps

Background District characteristics Disease Surveillance Dept. Pop:83,603 52% rural 36 prayer camps Health facilities 8 Public and 7 Private 1 PC, 1HC, 6 CHPS compounds HIV prevalence is 2.9 (2013) done by NMMRI Disease Surveillance Dept. collection of information on diseases and health events to facilitate prompt interventions towards the prevention and control of disease 52% rural- Easting side ( Ningo, Lekpongunor, Nyigbenya & Dawa and the Western side is Urban with few prayer camps ( Dawhenya)

Background 2 52% rural- Easting side ( Ningo, Lekpongunor, Nyigbenya & Dawa and the Western side is Urban with few prayer camps ( Dawhenya)

Issues Community members perceive numerous prayer camps as alternate sources of health care critical to include prayer camps in disease surveillance ART Clinic started in March 2016 201 clients have been put on ART By 2017, 24 (12%) had defaulted DSD embarked on an active case search to identify and trace defaulters who are on anti TB drugs and ART 24 (12%) defaulted – talk about the WHO 90 90 90 strategy, all client that tested + should be on trt for life

Description(1) DST visited 36 prayer camps Logistics required ( 1 pick-up, 4 personnel, test kits, lunch) 10 working days Only 1 prayer camp refused access to inmates 17 out of the 24 (70.8%) ART defaulters were traced and put on treatment. 62 clients were screened 6 tested positive All 6 are on ART 4 personnel-dco, district HIV focal person, 1-ART, 1-model of hope

Description(2) Educated leaders of prayer camps District data base on prayer camps updated- Other Observations Disease conditions seen ( HIV/AIDS, Tuberculosis, mental illness and maternal health issues e.t.c) Prescribed drugs seen (ARVs, Anti TB, Anti Malaria and Antibiotics e.t.c) Education-HIV, TB, mode of transmission, treatment, prevention and prayer camps updated from 25 – 36 camps

Scenes from prayer camps

3rd photo, leader boldly displaying prescribe drugs including ARVs, Anti TB, Antibiotics e.t.c., for clients on ARVs are supposed to be on it life, this may even result in Multidrug resistance to ARVs. At this very camp, one of our client on ARVs ended up at this camp, all her prescribe drugs including ARVs were seized from her, denied access to health care and even the ART Nurses, she finally died at the camp.

Lessons learnt Most prayer/spiritual leaders will cooperate and accept to work with the health facilities to provide holistic health to their clients.

Next steps Forge closer relationship with prayer camp operators and their clients Advocate for District Assembly to include prayer camp operations in their bye laws Since new prayer camps are springing up in the district, the exercise should be conducted regularly

Acknowledgements District Assembly Ningo-Prampram DHMT Old Ningo -Sub district Health Management Team Model of Hope Community Health Officers Prayer camp leaders

THANK YOU