Mass treatment for NTDs after COVID-19 in Nigeria

Main objectives

To assess the readiness of key neglected tropical disease (NTD) stakeholders to safely and effectively implement and monitor mass treatment programmes in the COVID-19 post-lockdown period in Nigeria
To explore the opinions of key NTD stakeholders on key aspects of readiness related to restarting NTD programmes, as well as how to ensure compliance of frontline workers, drug distributors and end-users to COVID-19 precautionary measures (wearing masks, physical distancing, contact tracing etc.)
To explore opinions of key NTD stakeholders on what the anticipated key barriers and challenges will be to implement, monitor, and support mass administration of medicines (MAM) activities, as well as how to maximise community engagement when restarting MAM

Summary

This mixed method study collected quantitative and qualitative data during one-to-one key informant interviews (conducted primarily over the phone and occasionally face-to-face with social distancing) with NTD stakeholders from Kaduna, Ekiti and Taraba states. Within each state, 57 purposively selected participants were selected from the level of the state, local government area, frontline health facility and community. There were varied response rates per state: 100% (57/57) in Taraba, 94.7% (54/57) in Kaduna, 93% (53/57) in Ekiti.

The quantitative results showed that:

Overall readiness score was the highest in Taraba (86%), followed by Ekiti (72%) and Kaduna (64%)
The areas of preparedness that scored consistently lower across the states were resource mobilisation; MAM training; COVID-19 surveillance; and partner communication/coordination
Stakeholders at local government area and community levels reported to be less prepared than state level stakeholders

Qualitative data from the three states corroborated the quantitative results and study participants indicated good knowledge of COVID-19 in terms of risks of transmission, clinical symptoms and preventive measures. The key challenges to MAM identified, particularly at community level, were misconceptions and myths about COVID-19, difficulties with reaching remote and marginalised populations and insufficient incentives for community directed distributors (CDDs).

What are the implications for policy and practice?

This is the first time that such research data has been collected to address NTD stakeholder preparedness in these states. While overall, the stakeholders reported to be ready to restart community treatment campaigns using adapted COVID-19 guidelines the findings from this study do call for improvements in the following areas: