Status: In progress
To understand the costs, cost drivers and impact of scaling up local context- specific NTD programme implementation in Kaduna and Ogun states through quantitative surveys and costing activities.
COUNTDOWN Nigeria has applied a Participatory Action Research (PAR) approach to improve equity of Mass Administration of Medicines (MAM) and inform Neglected Tropical Disease (NTD) policy through an enhanced community engagement strategy.
Following completion of the PAR approach, the participatory guide for planning Mass Administration of Medicine (MAM) was produced. The PGP is an interactive way to engage in participatory planning for context specific implementation of MAM for state coordinators, NTD local government coordinators and others. It provides knowledge and planning mechanisms for MAM including the need to plan programme activities based on context specific LGA macro and micro plans.
The quantitative aspect of this study will be in 2 sections – the first will examine the cost drivers of MAM activities, while the second will measure the success of the intervention in improving MAM coverage using a pre-post, intervention control design. The first survey took place before the current MAM cycle relating to the 2017 distribution and a second survey happened after the 2019 MAM cycle.
To estimate the cost of scaling up the intervention, we will use the ingredients approach and activity-based costing methods to document and quantify the costs of scaling up a ‘bottom-up’ participatory planning approach for Mass Administration of Medicines in Nigeria. The costing will focus on the supply side perspective including costs incurred at National, State, LGA and below. Costs will be measured in financial and economic terms. To guide collection of cost data, we have developed a costing template with details for each roll out model (1-3), the activity (e.g. meeting or training event), cost type (capital cost such as vehicle, non-capital cost such as staff time), cost category (e.g. person time, transport costs, materials), sub-cost categories (cadre of person, type of material), quantity and unit cost of resources used.
To measure the success of the intervention, we study the coverage of MAM in the previous and 2020 MAM cycle focussing on accessibility (people to who the drugs were made available) and adherence (people who took the medicines as directed). We hypothesis that community mobilisation and sensitisation packages will improve accessibility and adherence through increased acceptability and awareness of community members.
A descriptive analysis of both the baseline and follow-up data will be carried out to examine differences in accessibility and adherence before and after the intervention. Regression analysis will be used to study the factors that affect accessibility and adherence in the different LGAs of interest.
October 2019 – August 2020