Integrating neglected tropical diseases into primary healthcare services in Ghana: Results from an initial pilot

Background Neglected Tropical Diseases (NTDs) affect billions globally, including a significant burden in Ghana where at least two NTDs are endemic in every district. Integrating NTD services into primary health care (PHC) is critical for achieving Universal Health Coverage (UHC) and meeting the 2021–2030 NTD roadmap goals. This study piloted the integration of Ghana Health Service NTD indicators into the Community-based Health Planning and Services (CHPS) home visit register in Ghana to assess the feasibility of this approach for national scale-up. Methods A pilot implementation study was conducted in three districts representing different ecological zones in Ghana: Kassena Nankana West (northern), Nkwanta South (middle), and Ga South (southern). Following stakeholder workshops, the existing Community Health Officers’ (CHOs) home visit register was revised to include seven key NTD clinical indicators (blood in urine, skin lesions, visible deformities, eye complications, lymphoedema or swelling, suspected hydrocele and presence of a deep skin wound). A total of 64 Community Health Officers (CHOs) were trained to use the revised register during routine household visits over a three-month period (September to December 2023). Data on NTD cases identification, referrals, and referral compliance were collected and analyzed descriptively. Results A total of 1,932 home visits were conducted across 34 health facilities resulting in 1,117 suspected cases (observations of NTD-related indicators) identified, 615 referrals made with 67% compliance and district level compliance ranging from 6.5% to 92.1%. CHOs successfully identified various NTD-related conditions, with distinct geographical patterns observed. Blood in urine was most frequently reported in Ga South, while lymphoedema and eye-related complications were more commonly reported in Kassena Nankana West. The varying patient compliance with the referrals suggests important contextual differences in linkage to care. Over 85% of trained health workers were actively implementing their new skills. Conclusion Integrating NTD surveillance into the CHPS platform is feasible and yields valuable epidemiological data. However, the success of integration hinges not only on case detection but also on strengthening the linkage to care. The significant disparity in referral compliance highlights a critical health system bottleneck that must be addressed to ensure integrated services translate into improved health outcomes.