Status: In progress
The overall aim of the study is to strengthen the health system through information, education and capacity building of health workers to be able to provide the needed care, treatment and referral for women and girls affected by female genital schistosomiasis (FGS).
Schistosomiasis is one of the neglected tropical diseases (NTDs) targeted for elimination by 2030 as part of the sustainable development goals 3. A recent global interest in schistosomiasis is due to the impact it has on the reproductive system, particularly for women when it is known as FGS. FGS has great public health implications and consequences for women and girls affected. The current strategy for the control of schistosomiasis focuses only on school aged children (5 to 15 years) leaving out some schools, girls who do not attend school and women of reproductive age (> 15) thereby increasing their risk of FGS as they do not have access to treatment.
The Current National guideline for schistosomiasis control has no provision for management of FGS. Hence this study aims to raise awareness about FGS among health workers at local facilities and provide evidence-based information on how to detect and provide treatment care for those affected by FGS. This study will be carried out in two purposively selected local government areas (LGAs) in Ogun State (Abeokuta
North and Odeda LGA) where the cases of FGS have been confirmed.
A quality improvement (QI) process known as Plan-Do-Study-Act (PDSA) cycle will be used to develop and pilot a diagnostic algorithm, treatment package and referral system for management of FGS within the health system structure. PDSA cycle involves health workers in assessing problems, suggesting solutions and piloting the intervention.
This step involves identifying a goal or purpose, formulating an intervention or improvement (in this case diagnosis, treatment and referral systems for FGS for change and defining success metrics. It involves planning the intervention with a newly established FGS quality care implementation team who will explore the challenges and barriers to diagnosis and treatment, develop a diagnostic algorithm, treatment package and referral system for FGS.
This is the step in which the components of the plan are implemented. There will be a participatory workshop to educate and increase awareness of frontline health workers on FGS and build their capacity to be able to diagnose and provide the needed treatment for persons affected or refer them.
This step involves monitoring outcomes to test the validity of the plan for signs of progress and success, or problems and areas for improvement. This will include evaluation of the intervention and process (including interviews with health professionals and patients). We will conduct a review of the intervention process at 4 weeks initially and subsequently 12 weeks and 24 weeks intervals to understand what is working well and address any barriers to the intervention. This will be done through interviews with health workers and patients that access the care.
This step closes the cycle, integrating the learning generated by the entire process. All learnings at the different phases will be put together and used to develop, modify or improve the quality of the intervention approach. Final process evaluation will be conducted at the end of 6 months of project implementation.
October 2019 – August 2020