Study Setting
Ningo-Prampram
The study was conducted in the Shai-Osudoku and Ningo-Prampram districts in the Greater Accra Region, Ghana, at 4 public health facilities with basic laboratory services, 2 in each district. The Shai-Osudoku District Hospital is a 140-bed public hospital, St. Andrew's Catholic Hospital and Prampram Polyclinic are 30-bed facilities, and Old Ningo is a 3-bed health center. Prampram Polyclinic and Old Ningo were used as satellite sites of Shai-Osudoku District Hospital. Patients at these facilities were attended to by either medical doctors or physician assistants who were university-trained for 4 years.