To determine the feasibility and best practices of using the Supervisor's Coverage Tool to monitor community and school-based distribution and integrated MDA.
The Supervisor’s Coverage Tool (SCT) is a rapid, simple, and inexpensive tool designed for use in Neglected Tropical Diseases (NTD) programs mass drug administration (MDA) to monitor drug coverage and compliance, to supervise community drug distributors (CDD), and to identify areas that may need mop-up. After successfully piloting the SCT in Ethiopia and Nigeria in 2015, additional testing of the tool was suggested to assess the feasibility of the tool in different regions and new settings. Therefore, the SCT was implemented in the Philippines in July 2016.
After the completion of training, the field work was conducted in two provinces, in six Supervision Areas (SA) consisting of one or more puroks (subdivisions) per barangay (village). Two survey populations were represented in the SCT implementation covering a community-based distribution for Lymphatic Filariasis (LF), excluding children aged 5-18 years and a school-based distribution for LF for all children aged 5-18 years.
Findings and lessons learned:
- The most common reasons for not swallowing drugs were fear of side effects, not feeling well, forgetting, being too busy, and the taste of the medicine.
- When an accurate register of all the households in the SA exists, it is possible to complete the SCT in each SA in less than a day because the registers greatly aid the random selection process.
- Implementing the SCT during the last week or two of the MDA was advantageous as it enabled the program to implement the action plan to improve the current MDA using the personnel, budget, and infrastructure that was already in place for the MDA.
- It is important to consider whether or not Community Drug Distributors (CDD) should accompany the SCT teams during interviews, as their presence may influence the answers of the respondents.
- It is strongly recommended that when possible, CDDs use directly observed treatment (DOT). If DOT is not possible, CDDs should remind participants that there is no advantage in delaying swallowing the drugs, and that it is actually better when everyone swallows the drugs at the same time.
- Overall, the Philippines SCT pilot was a success, as it was the first time it was implemented in the Western Pacific region, and it was also used to monitor multiple distributions (both school- and community-based).