Stepping up to help stop the spread of COVID-19 in Ghana

A focus on border communities  

Border areas are particularly important to Ghana’s COVID-19 response. Not only are people in these areas at risk of the virus, they also come into contact with highly mobile groups, making them more vulnerable. In March, when borders between Ghana and other countries closed, stranded travellers continued to move between them, possibly to keep in touch with family members living on the other side or so they wouldn’t miss trading and economic opportunities. Due to this, testing for the virus was not initially available for these people, increasing the likelihood of transmission in these border communities.

Mahmoud Abdulaziz, managing district coordinating director for Nkwanta North District in the border region of Oti, is responsible for health services there. He says: “Because of the closure of the borders, people have created different unapproved routes. So even if a [testing] team is set up at the approved routes, then you have people using the unapproved route entry into the district, [and it is]… very difficult to be able to screen those who use the unapproved routes.”

“What we are doing is to liaise with the communities that have access to these [un]approved roads, and for them to be able to help… [by providing] community volunteers,” adds Mahmoud. “[They are then] identifying people who are using these routes, then inform[ing] the customs or the immigration, and also the chiefs and leaders, so that these individuals can be… screened.”

Sightsavers and partners have been supporting NTD work in these cross-border districts for many years. This meant a network of skilled community volunteers and health workers were already in place to trace and screen those moving across borders, and to raise awareness about COVID-19 in their communities. But first, this trusted network needed training.

Training the front line

Nii Ablade Nortey is one of the many health professionals who has stepped up to help with the COVID-19 response in border communities. Normally head pharmacist at Worawora government hospital, he put himself forward to train teachers and front-line health workers from 12 border areas to respond to the crisis.

“The aim [of the training] is to… build and develop the skills of the people who are more front-line on issues related to COVID-19,” says Nii. “We want to give them that education to build on their skill.”

As well as learning how to manage cross-border screenings, about 800 health workers have been trained to spot people with coronavirus symptoms and refer them to testing. They have also been trained to conduct contact tracing and shown how to implement and communicate prevention measures, such as social distancing, tackle COVID-19-related stigma and dispel rumours about coronavirus.

“Since it [coronavirus] started, if I even look at social media, we’ve had a lot of misinformation,” says Nii. “So it’s very important for us to have a forum where you bring in these critical people, and then you feed them with the right information so that they go out there and do the right thing.”

Changing minds

David K Agbavor, district health promotion officer for Kadjebi District in Oti, says the training confronted misconceptions about COVID-19 that even he held.

She is one of 200 teachers in Ghana who have been shown how to keep their schools COVID-19-safe, how to teach children and families about crucial preventative measures, and how to refer anyone with symptoms for testing.

“Health issues are in my heart,” she says. “I… decided to get involved because when the issue first came I needed… a way to learn more about what the virus entails so I can communicate it to my community.”

The COVID-19 behavioural change communication campaign, that was designed to target children, was created using age-appropriate language, characters, stories, music and humour, and appeared on television, radio and social media across the country. But teachers such as Amoah are also essential to ensuring children take part in practical activities that ensure messages about the virus get through.

“Our students resumed about two or three months ago, so we had training with them, together with their parents,” says Amoah. “We have signs that show the right way to wash their hands – I made sure the students did the drawing themselves so it would be easy for them to implement.

Amoah says the work of her and others on the COVID-19 front line is paying off.

“At this point, in my community about 95% have heard about the virus,” she says. “I saw a lot of people getting involved in the training, and I see a lot of people going around with masks on.”