Country ownership as a guiding principle for IA2030: A case study of the measles and rubella elimination programs in Nepal and Nigeria

Wonodi, Chizoba; Crowcroft, Natasha; Bose, Anindya Sekhar; Oteri, Joseph; Momoh, Jenny; Hughes, Genevieve; Shet, Anita; Pradhan, Rahul; Gautam, Jhalak Sharma; Jean Baptiste, Anne Eudes; Khanal, Sudhir; Masresha, Balcha; Linstrand, Ann

doi:10.1016/j.vaccine.2023.09.048

Cited by 1 publication

(1 citation statement)

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“…Although the vertical campaigns of NTD programs have proven effective, they are often not designed to improve primary healthcare systems. 37 Domestic financing, a pervasive theme in the qualitative results, is a critical component of program ownership 38,39 ; strategies to reduce costs include integrated impact surveys, reduced frequency of MDA (if prevalence is sufficiently low), incorporating deworming into a package of school health interventions delivered at specific school milestones, and supporting improvements in sanitation and hygiene. [40][41][42] Many programs have used integration of NTD activities to share funding and unlock domestic financing, although the amounts have generally been insufficient to sustain activities independently.…”

Section: Discussionmentioning

confidence: 99%

A Mixed-Methods Evaluation of Mainstreaming Mass Drug Administration for Schistosomiasis and Soil-Transmitted Helminthiasis in Four Districts of Nigeria

Griswold,

Eigege,

Emukah

et al. 2024

The American Journal of Tropical Medicine and Hygiene

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In Nigeria, mass drug administration (MDA) for schistosomiasis (SCH) and soil-transmitted helminthiasis (STH) has often been coordinated with other programs that receive greater external funding. As these programs reach stop MDA milestones, SCH and STH programs will likely need to transition implementation, or “mainstream,” to domestic support. A mixed-methods study was conducted in four districts before (2021) and after (2022) mainstreaming to evaluate its impact on MDA coverage. Household surveys were done in 30 villages per district pre- and post-mainstreaming. All selected communities were eligible for STH treatment; around a third were eligible for SCH treatment. Mass drug administration was primarily conducted in schools. A total of 5,441 school-aged children were included in pre-mainstreaming and 5,789 were included in post-mainstreaming. Mass drug administration coverage was heterogeneous, but overall, mebendazole coverage declined nonsignificantly from 81% pre-mainstreaming to 76% post-mainstreaming (P = 0.09); praziquantel coverage declined significantly from 73% to 55% (P = 0.008). Coverage was significantly lower among unenrolled children or those reporting poor school attendance in nearly every survey. For the qualitative component, 173 interviews and 74 focus groups were conducted with diverse stakeholders. Respondents were deeply pessimistic about the future of MDA after mainstreaming and strongly supported a gradual transition to full government ownership. Participants formulated recommendations for effective mainstreaming: clear budget allocation by governments, robust and targeted training, trust building, and comprehensive advocacy. Although participants lacked confidence that SCH and STH programs could be sustained after reductions in external support, initial results indicate that MDA coverage can remain high 1 year into mainstreaming.

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