The Role of Health Systems in the Control of Neglected Tropical Diseases in Sub-Saharan Africa

Nonvignon, Justice; Mensah, Ernest; Vroom, Frances Baaba da-Costa; Adjei, Sam; Gyapong, John

doi:10.1007/978-3-319-25471-5_17

Cited by 6 publications

(6 citation statements)

References 52 publications

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“…Delivering treatment to this group will require not only a supply side cost-effective integrated plan, but incorporation of a demand side approach through addressing nancial and non-nancial barriers associated with the involvement of patients' family and relatives who provide care, through actively engaging them in the design and implementation of policies that aim to address their needs. For example, since SSSDs are generally found in poor communities, if affected people were the only bread winners for their families, they would be more concerned about their family food needs and survival than seeking medical care at health facilities consistent with the authors [22,28,30,31] ndings from the literature. Our results also revealed that patients delay care seeking to obtain food and other necessities for their family, which is in keeping with ndings from other studies which highlighted the need to consider loss of wages prior to seeking care for SSSDs…”

Section: Patient Pathway Barriers: Nancialsupporting

confidence: 63%

Financing Care for Severe Stigmatizing Skin Diseases (SSSDs) in Liberia: Challenges and Opportunities

Smith

Diaconu

Witter

et al. 2022

Preprint

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IntroductionNeglected tropical diseases (NTDs) are an important global health challenge, however, little is known about how to effectively finance NTD related services. Integrated management in particular, is put forward as an efficient and effective treatment modality. This is a background study to a broader health economic evaluation, seeking to document the costs of integrated care management of NTDs versus standard care in Liberia. In the current study, we document barriers and facilitators to NTD care from a health financing perspective.MethodsWe carried out key informant interviews with 86 health professionals and 16 national health system policymakers. 46 participants were active in counties implementing integrated case management and 40 participants were active in counties implementing standard care. We also interviewed 16 patients and community members. All interviews were transcribed and analysed using the thematic framework approach. FindingsWe found that decentralization for NTD financing is not yet achieved – financing and reporting for NTDs is still centralized and largely donor-driven as a vertical programme; government involvement in NTD financing is still minimal, focused mainly on staffing, but non-governmental organisations (NGOs) or international agencies are supporting supply and procurement of medications. Donor support and involvement in NTDs are largely coordinated around the integrated case management. Quantification for goods and budget estimations are specific challenges, given the high donor dependence, particularly for NTD related costs and the government’s limited financial role at present. These challenges contribute to stockouts of medications and supplies at clinic level, while delays in payments of salaries from the government compromise staff attendance and retention. For patients, the main challenges are high transportation costs, with inflated charges due to fear and stigma amongst motorbike taxi riders, and out-of-pocket payments for medication during stockouts and food/toiletries (for in-patients).ConclusionOur findings contribute to the limited work on financing of SSSD services in West African settings and provide insight on challenges and opportunities for financing and large costs in accessing care by households, which is also being exacerbated by stigma.

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Section: Patient Pathway Barriers: Nancialsupporting

confidence: 63%

Financing Care for Severe Stigmatizing Skin Diseases (SSSDs) in Liberia: Challenges and Opportunities

Smith

Diaconu

Witter

et al. 2022

Preprint

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“… 45 Other factors such as poor road networks in endemic populations, inadequate transport resources for supervisory teams and remoteness of some communities are also known to affect timeliness of reporting. 46 This becomes even harder when MDAs are conducted during the rainy season in these poor remote areas.…”

Section: Introductionmentioning

confidence: 99%

Elimination of lymphatic filariasis: current perspectives on mass drug administration

Gyapong¹,

Owusu²,

Vroom³

et al. 2018

RRTM

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Following the London declaration on neglected tropical diseases (NTDs) in 2012 and inspired by the WHO 2020 roadmap to control or eliminate NTDs, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) intensified preventive chemotherapy and management of morbidity as the two main strategies to enhance progress towards the elimination of lymphatic filariasis (LF). This paper focuses on current perspectives of mass drug administration (MDA) towards the elimination of LF. The goal of MDA is to reduce the density of parasites circulating in the blood of infected persons and the intensity of infection in communities to levels where transmission is no longer sustainable by the mosquito vector. Three drugs, diethylcarbamazine, albendazole, and ivermectin are currently available for LF treatment, and their effectiveness and relative safety have opened the possibility of treating the entire population at risk. Currently, almost all LF endemic countries rely on the single-dose two-drug regimen recommended by the GPELF to achieve elimination. The 4th WHO report on NTDs has indicated that considerable progress has been made towards elimination of LF in some countries while acknowledging some challenges. In this review, we conclude that the 2020 elimination goal can be achieved if issues pertaining to the drug distribution, health system and implementation challenges are addressed.

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“…Weak health systems in NTD endemic areas pose a challenge to the delivery of interventions at adequate levels to at-risk populations. To effectively reach target populations with NTD treatment, weak health systems challenges must be addressed by fixing specific weaknesses in the HS building blocks-service delivery, health workforce, information, medical products and technologies, financing, and leadership and governance [47].…”

Section: Discussionmentioning

confidence: 99%

Understanding the Role of Health Workers in the LF Elimination Program in Kenya: Challenges Faced and Suggestions for Improved Program Performance

Kimani

Kibe

Okoyo

et al. 2021

East Afr. j. health sci.

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The Kenyan Ministry of Health and its partners through the Division of Vector-Borne and Neglected Tropical Diseases, is in charge of the Lymphatic Filariasis Mass Drug Administration programme. This is implemented through the national, county, and sub-county neglected tropical diseases coordinators. The current study sought to understand the roles, challenges faced and suggestions of how program performance can be improved by the community health extension workers, county and sub-county neglected tropical diseases coordinators. Two wards of the Kaloleni sub-county; Kilifi County were purposively selected. In 2015, Kaloleni and Kayafungo wards had a treatment coverage of 58% and 54% respectively; 62% and 39% respectively in 2016, all below the recommended minimum treatment coverage of 65%. Qualitative data was collected through sixteen in-depth interviews with community health extension workers and two semi-structured interviews with the county and sub-county neglected tropical diseases coordinators. Data were analysed by QSR NVIVO version 10 according to identified themes. The study results show the various roles in planning and implementation of the program include; supply chain management; health information education communication and records management; health workforce training and management, leadership and governance, and service delivery. Challenges faced included insufficiency of drugs supplied and information education communication materials, the inadequacy of community drug distributors selected and trained, poor facilitation for training and supervision of community drug distributors, limited duration of the mass drug administration, and delayed reporting due to poor network coverage. The results of this study show that the community health extension workers, county and sub-county neglected tropical diseases coordinators are not fully involved in program leadership and governance, a role that is taken up at the national level. They should be involved in all the stages of the mass drug administration program to create ownership to improve the program performance

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The Role of Health Systems in the Control of Neglected Tropical Diseases in Sub-Saharan Africa

Cited by 6 publications

References 52 publications

Financing Care for Severe Stigmatizing Skin Diseases (SSSDs) in Liberia: Challenges and Opportunities

Financing Care for Severe Stigmatizing Skin Diseases (SSSDs) in Liberia: Challenges and Opportunities

Elimination of lymphatic filariasis: current perspectives on mass drug administration

Understanding the Role of Health Workers in the LF Elimination Program in Kenya: Challenges Faced and Suggestions for Improved Program Performance

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