Morbidity management

Morbidity management for hard to reach populations in insecure areas in Burkina Faso: analysis of barriers and determination of the resilience of the health system

The study aims to identify the most effective approaches for case management and delivery of surgical services for IDPs and migrants suffering from LF and/or trachoma in security compromised areas. Barriers to reaching morbidity patients will be assessed, in addition to determinants of the institutionalizatoin of NTD morbidity management within the national health system. Research aims will be addressed through the following key activities: document review and direct inspection protocols to determine health facilities' ability to provide MMDP services; active case finding including creation of WhatsApp groups and SMS messaging to help keep track of patients and refer them to care; key informant interviews with health workers and community leaders to assess behavior change communication strategies for raising awareness among affected individuals; one-on-one interviews and focus group discussions with patients to understand barriers to care; and stakeholder engagement to increase buy-in and identify ways to operationalize MMDP services within national program.

Countries: Burkina Faso

IMPRESS – Improving access to integrated Morbidity management and disability PREvention Services through Stigma reduction for people with lower limb lymphoedema in Ethiopia: Feasibility and quasi-experimental study (year 2)

  • Formative component: What is the capacity of the integrated morbidity management and disability prevention (MMDP) programme to incorporate a stigma reduction intervention for people with lower limb lymphoedema, and what are the barriers and facilitators to this?
  • Intervention component: Is the stigma reduction intervention effective in increasing demand and access to services within an integrated MMDP programme for people with lower limb lymphoedema?
Countries: Ethiopia

Integration of LF morbidity management and disability prevention (MMDP) into community health services: exploring the coverage and equity of community health worker-driven LF MMDP burden assessment and service uptake in Côte d’Ivoire.

This study will test the reliability of community health worker-led (CHW) MMDP burden estimates by having CHWs first estimate MMDP burden, followed by a rigorous population-based survey to get a representative estimate of MMDP burden for the district. Six months later, these cases will be followed up to see whether they accessed the MMDP services and assess the quality of care. The study will examine the accuracy of the CHW estimates, CHWs’ ability to diagnose properly, social biases of health care workers that may prevent equitable care delivery, and the cost comparison of the CHW method vs. population-based survey. In addition, the team plans to conduct an evaluation of the quality of MMDP service provision, including available psychosocial support, at all facilities in the selected health district. Programs need a feasible and reliable method for coming up with MMDP burden estimates for LF and strategies to ensure that people have access to care and utilize that care. This study addresses the two pillars of WHO dossier development for MMDP and will provide the Ministry of Health with essential information to plan and adapt their program to accommodate MMDP services.

Countries: Cote d'Ivoire

Developing an appropriate model of care for lymphatic filariasis and leprosy patients who need MMDP services in Bihar State, India

What is the comparative effect of enhancing the existing MMDP services with or without community-based components in significantly reducing the burden of Acute Attacks (AA), Hydrocele, and Mental Health (MH) issues among people affected by LF?

Countries: India

The influence of stigma on social participation and mental well-being amongst men and women affected/disabled by lymphatic filariasis and leprosy in the districts of Jaunpur and Patna in India

To what extent does stigma affect social participation and mental wellbeing among men and women affected/disabled by lymphatic filariasis or leprosy in Jaunpur in Uttar Pradesh and Patna in Bihar?

Countries: India

Trachomatous Trichiasis and Mental Health: a comparative impact study

This study aims to understand the relationship between trachomatous trichiasis (TT) and mental health disorders over an 18-month study period, by answering the following questions:

  1. What is the impact of the blinding stage of trachoma (Trachomatous Trichiasis) on common mental disorders such as depression, anxiety and suicidality?
  2. Will the validation of the 5-Question Stigma Indicators (5-QSI) generic stigma tool help to measure and monitor stigma in trachomatous trichiasis patients in Ethiopia
  3. What are the drivers for mental disorders in TT patients
  4. Is there a difference in depression, anxiety and suicidality prevalence between TT cases accepting vs declining TT surgery; and un-operated vs postoperative TT cases? The research team will be trained on good clinical practice through the WHO Mental Health Gap Action Programme (mhGAP). Following interviews, any patient with TT will be referred for surgery and patients found with a mental health disorder will be referred for care. If a negative impact of blinding trachoma on mental health is noted, the researchers plan to use the results of the study to advocate for additional funding for the trachoma program and highlight the need to address mental health in Ethiopia.
Countries: Ethiopia
Diseases: Trachoma

Trachomatous Trichiasis Management in Tanzania: Investigation of the productivity of case finding and referral of patients to trichiasis surgery services

One of important pillar of Trachoma elimination as a public health problem is to manage through epilation and surgery trachomatous trichiasis (TT) to reach in endemic district less than 0.1% of TT prevalence or less than 0.2% prevalence in adults of 15 years and older. However, surveys in 3 districts of Tanzania where numbers of TT surgeries were performed showed an unexpected higher prevalence despite intervention. This mixed methods study will help to address the main question as to why trachoma impact surveys demonstrating unexpectedly high TT prevalence in communities where TT surgical intervention is ongoing and how could this intervention/burden gap be addressed? The aim is to look at the case finding techniques effectiveness in all the communities and factors that affect TT referral and quality surgical services.

Countries: Tanzania
Diseases: Trachoma

Improved delivery of / access to Morbidity Management and Disability Prevention (MMDP) / Disease Management, Disability and Inclusion (DMDI) for persons affected by lymphatic filariasis, leprosy, and/or konzo in Nampula, Mozambique

Formative: What is the capacity of the Mozambican health system in general, and the NTD programme more specifically, to provide MMDP/DMDI services for people affected by leprosy, LF and konzo, and what are some of the barriers and facilitators to access these services?

Intervention: Which strategies are currently in place to provide quality healthcare for persons with disabilities, especially those that are caused by leprosy, LF and konzo, and how are MMDP/DMDI services organized vis-à-vis other disease control programs/health service delivery platforms?

Countries: Mozambique

The Impact of an Integrated Health System Approach in Improving Access to Morbidity Management and Disability Prevention Services for Persons with Leprosy, Hydrocele, and Lymphoedema in Coastal Kenya

Formative: To what extent do individuals have quality of life and access to and utilize MMDP services within the healthcare system; and what are the barriers and facilitators (affordability, availability, approachability, acceptability, and appropriateness) of 1) access to and utilization of quality MMDP healthcare services and 2) management of morbidities at home?

Intervention: What is the effect of an integrated health system approach on access to MMDP healthcare services as measured by affordability, accessibility, acceptability, and availability; and on utilization of services and quality of life?

Countries: Kenya

IMPRESS – Improving access to integrated Morbidity management and disability PREvention Services through Stigma reduction for people with lower limb lymphoedema in Ethiopia: Feasibility and quasi-experimental study

Formative: What is the capacity of the integrated morbidity management and disability prevention (MMDP) programme to incorporate a stigma reduction intervention for people with lower limb lymphoedema, and what are the barriers and facilitators to this?

Intervention: Is the stigma reduction intervention effective in increasing demand and access to services within an integrated MMDP programme for people with lower limb lymphoedema?

Countries: Ethiopia

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