Willingness to Accept Malaria Mass Drug Administration Using the Theoretical Framework of Acceptability in an Urban Municipality of Ghana: A Cross-Sectional Study

Background Malaria continues to pose a major public health threat in sub-Saharan Africa, with Ghana accounting for 2.5% of all malaria cases in the region. Mass drug administration (MDA) has emerged as a viable intervention for malaria elimination, yet its success largely depends on community acceptance and adherence, particularly when asymptomatic individuals are required to take antimalarial drugs. The study assessed the willingness of adults in the La Dade-Kotopon Municipality (LaDMA) of Ghana to accept Malaria MDA programs, particularly using dihydroartemisinin-piperaquine (DHAP). Methods This study employed a cross-sectional study design involving 421 adults from two communities in LaDMA. Household sampling was used in the selection of participants. A total of 421 households were sampled in the two communities. A structured questionnaire was administered to participants. Acceptability of MDA was assessed using Sekhon et al seven Theoretical Framework of Acceptability (TFA) constructs. Both descriptive and inferential analyses were conducted at an alpha level of 0.05. Results The mean age of the participants was36 years and 57.5% were females. Majority (58.7; 95% CI 54.0–63.0) of the participants in LaDMA found the malaria MDA program acceptable and will be willing to participate in it. The factors associated with acceptability of the malaria MDA were age ( p  = 0.001), community ( p  = 0.004), level of education (p = 0.033), occupation ( p = .0.003), monthly income ( p  = 0.042), religion (p < 0.001), tribe (p < 0.001), cultural permissions (p = 0.022) and community wellbeing (p < 0.001). Individuals aged 50–59 years had 66% lower odds of MDA acceptability compared to those aged 18–29 years (aOR = 0.34, 95% CI: 0.11–0.95, p  = 0.040). Those with tertiary education had 72% lower odds of MDA acceptability compared to those with primary education (aOR = 0.28, 95% CI: 0.09–0.86, p  = 0.027). Ewes had 68% lower odds of MDA acceptability compared to Gas (aOR = 0.32, 95% CI: 0.12–0.82, p  = 0.019) Conclusion Willingness to accept malaria MDA program is moderate. Residents who agreed to participate in MDA programs for purposes of community wellbeing found MDA more acceptable compared to those who disagreed. Emphasizing community-wide benefits may enhance participation in future MDA programs.