Integrating Preventive Treatment for Female Genital Schistosomiasis within the National Health System: a Pilot Study in Cote d’Ivoire
This study aims to integrate screening and preventive treatment with praziquantel for FGS into routine HIV and reproductive health care visits for women. A pilot study will be conducted in four health facilities with a target sample size of 4800 women over a six-month period. Trainings will be conducted for health workers and the team will use a participatory design process with key stakeholders to ensure that barriers to integration in the health system and community participation are addressed. A scale-up report will be written with stakeholder engagement and all training materials that were developed will be instantly available for use in other clinics in Cote d’Ivoire. Delivery of praziquantel to the four facilities in the pilot study will utilize existing drug-procurement and delivery systems to ensure sustainability.
Female Genital Schistosomiasis in rural Madagascar: improving community understanding and promoting integration into primary health care services- FIRM-UP
The study will take place in the context of a larger clinical trial (FIRM-UP) that includes 4000 women affected by schistosomiasis. For the current study, the team will develop the following “work packages” to better understand community awareness of FGS, clinical diagnosis, and how to provide enhanced training:
- Work Package 1: design and implement a community-based awareness campaign, using community surveys, focus group discussions, and in-depth interviews, to determine uptake and acceptability of FGS services. This will be followed with an end-line survey to assess change in the indicators following the campaign.
- Work Package 2: establish a diagnostic package with digital colposcopy (using smartphones to capture images) and on-site microscopy.
- Work Package 3: provide a refresher training for FIRM-UP study workers, organize a colposcopy and digital imaging workshop, and extended training for staff coming from other endemic regions in Madagascar. An open-source learning platform (‘Moodle’) will be developed to exchange training and learning materials.
Can geospatial algorithms be used by disease programs to help identify hotspots at community and Implementation Unit level?
Improving Neglected Tropical Disease (NTD) services and integrating into primary health care in Southern Nations, Nationalities, and Peoples' Region (SNNPR), Ethiopia
This study outlines an important first step to understanding NTD program integration in Ethiopia and builds on previous work in SNNPR. The study team plans to carry out significant formative research to better understand what gaps currently exist in the Ethiopian primary health care system that prevent integration of NTD services. They aim to answer the following questions:
- What are the current gaps in the Ethiopian primary health care system for implementing integrated NTD services and how can they be addressed?
- What is the community’s perception and awareness of selected NTDs and how can it be improved?
Following the gap analysis, the study team, along with the ministry of health and NTD taskforce of Ethiopia, will develop interventions to address these gaps. Outputs of the intervention stage are expected to include the following: a detailed description of the intervention, including case definitions, roles and responsibilities at the different levels of the health system, data recording and reporting mechanisms, referral systems; training manuals for the different primary healthcare system levels, job aids, guidance for supportive supervision. The team has made extensive plans to address issues of sustainability and scalability of the project including a cost analysis of the interventions, developing close partnerships with health facilities’ procurement departments, and close engagement during budget planning exercises of district health offices.
Integrating NTD programme monitoring into routine health systems data: evaluating a DHIS2 platform for real-time mass administration of medicines (MAM) reporting
This study includes an assessment of the Sightsavers rollout of a DHIS2 based tool for data collection in the NTD program in 2 states in Nigeria. In particular, the research project seeks to evaluate the health system strengthening effects of the tool for planning, monitoring and reporting of MDA. They plan to examine:
- the functionality of the tool at scale
- ease of integration across different NTD interventions
- data accessibility, accuracy, timeliness, and usefulness.
The team also aims to understand whether the implementation of this tool would enhance government ownership of the data and the NTD programme in general. This research will aid in identifying barriers and opportunities for potential scale up of the tool throughout Nigeria. The team also plans to focus on understanding how the data will be used at different levels of the health system.
The Zambia Neglected Tropical Disease Control Programme’s role in the attainment of Universal Health Coverage in Zambia: an implementation research study.
This study aims to conduct a landscape analysis to better understand the implementation context for the NTD control programme in Zambia. The activities include:
- an assessment of institutional structures, service delivery systems, existing resources/capacity
- mapping gaps, facilitators, and barriers to program implementation
- identifying potential opportunities to introduce innovative approaches for program integration and improvement.
Key informant interviews and focus group discussions with policy makers and NTD program officers will complement an extensive document review. The results of this assessment will be fed into the next National Health Strategic Plan, which expires in 2021.
Assessing the effectiveness of using the Community Directed Intervention (CDI) approach to improve community ownership of Mass Drug Administration (MDA) for Neglected Tropical Diseases (NTDs) in Malawi
This project intends to assess the effectiveness of using the Community Directed Intervention (CDI) approach as a vehicle for delivery of mass drug administration (MDA) campaigns against targeted NTDs namely, schistosomiasis and soil-transmitted helminths (STH) such as Ascaris lumbricoides (roundworms), Trichuris trichiura (whip worms) and Ancylostoma sp. (hookworms) in selected districts of Malawi. The idea is to take advantage of the logistical setup, organizational strength and high degree of efficiency of the national NTD programme to improve delivery of the current MDA efforts to control selected and highly prioritized NTDs of schistosomiasis and STH and to enhance community ownership of the interventions in selected rural and remote communities by using the CDI approach. The primary research question is: Can the CDI approach be effectively used to deliver MDA to control NTDs at community level in rural Malawian districts?
Interrogating “big data” to develop a user-friendly analysis framework for gender equity in MDA to ensure no one is left behind in Neglected Tropical Disease interventions in Nigeria
To develop and pilot a standardised analytical framework for the spatial and temporal analysis of routinely collected gender disaggregated NTD programme data. This will allow increased understanding and spatial visualisation of the influence of gendered programmatic inputs, external geographic and social factors on the equity of programmatic outputs, particularly access to mass administration of medicines (MAM).
A pilot study to identify meaningful and measurable targets for detecting the control of schistosomiasis-related morbidity in Africa. The overall study is designed to answer the following primary evaluation questions:
- What are the infection levels of Schistosoma mansoni and S. haematobium below which there is little, or no, detectable schistosomiasis-associated morbidity?
- What are the optimal morbidity markers for S. mansoni and S. haematobium?
- What are the optimal species-specific morbidity goals for which schistosomiasis control programs should be aiming?
Towards sustainability of Schistosomiasis Control: improving health of lake shore communities and engaging civil society structures, educational and health facilities in the hyper-endemic area of Mwanza, Tanzania
Schistosomiasis is among the neglected tropical diseases which are highly endemic in Tanzania, especially along and on the Island of Lake Victoria, in northwestern region. After Nigeria, Tanzania is second country in sub-Saharan Africa for having the highest prevalence of schistosomiasis infection and it is estimated that 52% of approximately 50 million people are living with the disease. Current control strategies in Tanzania focus on mass drug administration (MDA) of Praziquantel (PZQ) mainly in school children. Despite of these efforts, the burden of disease remains high, showing local infection rates of up to 97% among school children. School- based MDA alone is unlikely to have a lasting effect on transmission. Awareness creation and engagement across sectors and of civil society (cooperatives, community councils) structures will help to achieve more sustainable results. The objective of this project is to engage affected communities and civil society structures representing risk population (cooperatives, beach management units) to create awareness through e.g. CHAST (children’s hygiene and sanitation training), participation in control activities and improved health seeking behaviors. Secondarily, the study aims to institutionalize measures for early diagnosis and treatment in health facilities of Nyamagana and Ilemela district, along the Lake Victoria, northwestern Tanzania.