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Background <p>Intermittent preventive treatment for school-aged children (IPTsc) is a newly recommended malaria chemoprevention strategy targeting populations that increasingly sustain malaria transmission in sub-Saharan Africa. Ghana recently added IPTsc into its national malaria strategy, yet evidence on community acceptability and implementation strategies in non-trial settings remains limited. This study explored perceived barriers, facilitators, and preferred implementation strategies for IPTsc in a high-transmission district in Ghana.</p> Methods <p>An exploratory qualitative study was conducted in four junior high schools in the Hohoe Municipality. Data were collected through five focus group discussions (FGDs), comprising four FGDs with school-aged children and one FGD with caregivers. Additionally, three key informant interviews (KIIs) were conducted with two headteachers and the municipal School Health Education Programme coordinator. Transcripts were analysed using Attride-Stirling’s thematic network analysis framework.</p> Results <p>Perceived barriers included concerns about drug origin, fear of side effects, administering medicines to asymptomatic children, tablet size and taste, and doubts about programme continuity. Facilitators centred on perceived benefits such as reduced malaria episodes, improved school attendance, lower household treatment costs, and community willingness to support IPTsc if adequate sensitisation was provided. Preferred implementation strategies included school-based delivery complemented by community outreach, administration by trained health professionals, clear communication on drug timing and food intake, and early parental involvement.</p> Conclusion <p>In this setting, perceived acceptability of IPTsc was shaped less by doubts about effectiveness and more by concerns about trust, safety, delivery, and programme continuity. These findings suggest that context-sensitive IPTsc implementation in similar high-transmission settings should prioritise community engagement, involvement of health professionals, and adaptive delivery models that link schools with community health platforms.</p>

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“We are not sick, so why take medicine?” Community perspectives on barriers, facilitators, and implementation strategies for IPTsc in Ghana

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月15日

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  • Joseph Sam,
  • Emmanuel Asampong,
  • Harriet Affran Bonful,
  • Dora Dadzie,
  • Mahnaz Vahedi

摘要

Background

Intermittent preventive treatment for school-aged children (IPTsc) is a newly recommended malaria chemoprevention strategy targeting populations that increasingly sustain malaria transmission in sub-Saharan Africa. Ghana recently added IPTsc into its national malaria strategy, yet evidence on community acceptability and implementation strategies in non-trial settings remains limited. This study explored perceived barriers, facilitators, and preferred implementation strategies for IPTsc in a high-transmission district in Ghana.

Methods

An exploratory qualitative study was conducted in four junior high schools in the Hohoe Municipality. Data were collected through five focus group discussions (FGDs), comprising four FGDs with school-aged children and one FGD with caregivers. Additionally, three key informant interviews (KIIs) were conducted with two headteachers and the municipal School Health Education Programme coordinator. Transcripts were analysed using Attride-Stirling’s thematic network analysis framework.

Results

Perceived barriers included concerns about drug origin, fear of side effects, administering medicines to asymptomatic children, tablet size and taste, and doubts about programme continuity. Facilitators centred on perceived benefits such as reduced malaria episodes, improved school attendance, lower household treatment costs, and community willingness to support IPTsc if adequate sensitisation was provided. Preferred implementation strategies included school-based delivery complemented by community outreach, administration by trained health professionals, clear communication on drug timing and food intake, and early parental involvement.

Conclusion

In this setting, perceived acceptability of IPTsc was shaped less by doubts about effectiveness and more by concerns about trust, safety, delivery, and programme continuity. These findings suggest that context-sensitive IPTsc implementation in similar high-transmission settings should prioritise community engagement, involvement of health professionals, and adaptive delivery models that link schools with community health platforms.