Healthcare professionals’ experiences managing cerebrospinal meningitis in the Upper West Region, Ghana: a qualitative study

Meningitis remains a persistent public health challenge in Ghana's Upper West Region, particularly in districts prone to recurrent outbreaks. The region recorded significant outbreaks in recent years, including the 2022-2024 cerebrospinal meningitis (CSM) upsurge, which strained local health systems and exposed persistent systemic gaps. Healthcare professionals play a crucial role in case detection, management and prevention, yet systemic challenges hinder their effectiveness. This study aimed to explore healthcare professionals' experiences and challenges in managing CSM outbreaks in Ghana's Upper West Region. This qualitative study was conducted between January and June 2024. It involved in-depth interviews with 35 purposively selected healthcare professionals, including physicians, nurses, laboratory technicians and public health officers from five high-risk districts: Jirapa, Lawra, Nandom, Nadowli-Kaleo and Wa West. Data were collected using a semi-structured interview guide and analysed thematically. Participants reported multiple challenges in managing CSM outbreaks, including delayed patient reporting, limited diagnostic capacity, insufficient supplies of essential medicines, shortages of trained healthcare personnel and inadequate referral and transportation systems. These difficulties were further compounded by weak policy and institutional support, community-level and prevailing misconceptions about the disease and gaps in timely surveillance data, all of which hindered effective outbreak detection, monitoring and response. Findings suggest that a multifaceted approach is needed to address the identified challenges, particularly those related to diagnostic limitations, medicine supply gaps, human resource constraints, referral inefficiencies and gaps in community knowledge and surveillance. Addressing these specific systemic and operational gaps may help strengthen outbreak response capacity in meningitis-prone districts.