Impact of Decentralization of Pharmacovigilance Activities to Lower-Level Health Facilities in Ghana

Introduction: Medicinal products play an important role in the prevention and treatment of diseases, however, they may also cause adverse effects. Spontaneous reporting is the most widely employed method for reporting adverse effects of medicinal products. In Ghana, most spontaneous reports are received from tertiary, regional, and district hospitals with little or no reports from the lower-level health facilities, namely, clinics, health centres, and Community Health Planning and Services. The National Pharmacovigilance Centre started a project in April 2021 to decentralize pharmacovigilance activities to the lower-level facilities to improve the safety monitoring of medicinal products at these levels because 81.4% of Ghanaians access their health needs at the primary healthcare facilities. [1] Aim: To assess the impact of decentralization of pharmacovigilance activities to the lower-level health facilities in Ghana. Method: A descriptive cross-sectional study was conducted from 6th March 2023 to 30th April 2023 to assess the impact of decentralization of pharmacovigilance activities on the knowledge and practices of healthcare workers on patient safety activities at the lower-level health facilities in Ghana. A pre-test and post-test questionnaire was administered to 421 participants in a pharmacovigilance training program across 13 out of the 16 administrative regions in Ghana to assess their knowledge of pharmacovigilance. To measure the impact of knowledge, the paired T-test was employed. In addition to the pre-test and post-test questionnaire, 70 randomly selected participants were followed up to complete an online questionnaire 23 months after the training to review the impact of the training program by assessing reporting rates and other patient safety initiatives implemented at their facilities to promote patient safety. Results: The results showed that the impact of knowledge was significant at p\0.05(p-value 0.00002) with the value of t being 6.39. There was a 381.8% increase in the number of individual case safety reports (ICSRs) received for medicinal products after the training. All participants (n = 421) who took part in the training downloaded the Med Safety app, a tool for reporting ICSRs. We also found that 63(90%) participants who took part in the training programs and completed the questionnaire had trained 608 healthcare professionals at their healthcare facilities. Conclusion: Decentralizing pharmacovigilance activities to the lower-l