Posts or Comments 06 July 2022

Monthly Archive for "November 2017"

CHW &IPTp &Malaria in Pregnancy Bill Brieger | 05 Nov 2017

Improving Early ANC Attendance and IPT Uptake through Community Health Volunteers

Community health workers are playing an increasing role in maternal health programming.  Augustine Ngindu, Susan Ontiri, Gathari Ndirangu, Beth Barasa, Evans Nyapada, David Omoit, Johnstone Akatu, and Mildred Mudany of The Matewrnal and Child Survival Program, The Kenya Ministry of Health and Jhpiego share their experiences in Kenya at the 66th Annual Meeting of the American Society of Tropical Medicine and Hygiene in Baltimore on 2017-11-06.  If you are in Baltimore, hear more at Scientific Session 13. Below is an abstract of their presentation

Kenya adopted the use of intermittent preventive treatment with sulfadoxine pyrimethamine in 1998 but the proportion of pregnant women receiving at least two doses (22% (2010) and 56% (2015) has remained below the national target of 80%. In 2015, the country adopted an IPTp3 indicator for monitoring IPTp uptake; that year, the proportion of women taking at least 3 doses was 38% (2015).

Some of the factors leading to low IPTp coverage include poor knowledge on the need for early antenatal care (ANC), distances to health facilities, sociocultural practices and a lack of financial resources. In 2012, community health volunteers (CHVs) were enlisted through a pilot program in one county to deliver messages aimed at increasing the proportion of women starting ANC ? 20 weeks of gestation and thus expand the proportion of women receiving IPTp early in the second trimester.

A community survey in 2013 showed an increase in IPTp2 from 22% in 2010 to 63%. The practice was considered a success story, and was subsequently replicated in 30 sub-counties, in 4 out of 14 malaria endemic counties. The rollout involved training of 9,042 CHVs, in 761 community units. Between 2015 and 2016, the CHVs reached 86,433 women with MiP messages. During this time, there was an average increase in IPTp1 from 51% to 68%, and IPTp2 increased from 42% to 55% (p? 0.001). This could be attributed to early ANC attendance, which increased from 32% to 48% in the same period.

The use of CHVs to sensitize pregnant women to start IPTp early in the second trimester and continue with scheduled ANC visits increases the probability that women will receive the recommended IPTp-SP doses. The rollout of the practice to other malaria endemic counties is likely to have contributed to increase in IPTp uptake in the four target counties.


NTDs Bill Brieger | 05 Nov 2017

Online Survey to Elicit Views of Technical Support from Endemic Country Neglected Tropical Disease Managers

An online survey was part of the process of an evaluation of USAID’s NTD program conducted by the Johns Hopkins Bloomberg School of Public Health. William R. Brieger, Adebamike Oshunbade, Gilbert Burnham, Violetta Yevstigneyeva, Emily Wainwright, and Darin Evans present the process and brief findings from the online survey Monday (20171106) during Poster Session A of the American Society of Tropical Medicine and Hygiene 66th Annual Conference in Baltimore. If you are there, look for Late Breaker Poster #5111. The poster abstract is provided below.

Neglected Tropical Diseases (NTDs) are a diverse group of communicable diseases prevailing in tropical and subtropical conditions in 149 countries and affect more than one billion people, especially those in poverty. Since 2006 The US Agency for International Development has working with global and national NTD partners to control or eliminate 5 NTDs that respond to preventive chemotherapy delivered through mass drug administration at the community level.

As part of an evaluation of this effort, an online survey was conducted with endemic country NTD staff to learn their views on the successes and challenges of USAID NTD program support. A 22-question 3-part survey of closed and open-ended responses was posted online through Survey Monkey.  A list of emails of government, NGO and donor NTD staff from 21 endemic countries was compiled. After 3 contacts, 44 English and 22 French speakers responded.

Most respondents thought Global NTD goals aligned adequately or fully (88%) with national priorities. Respondents valued regular technical assistance from USAID as 76% rated help in annual planning useful or very useful, and well-coordinated with their own annual planning (71%). Most (71%) said the USAID NTD program had been effective in communicating its goals and accomplishments among country partners.

Respondents felt that documentation and dissemination of success stories could be strengthened. Specific USAID contributions were valued: “USAID gives an orientation on the tools to use, shares the guidelines to follow-up and does comments for clarifications.” When asked about integration of NTDs with other programs (WASH, PHC, and MNCH), 81% of respondents felt this was achieved to some degree, but recognized a need for national ministries to take a stronger lead.  Concerning strengthening national leadership, 81% felt USAID support helped.

The online survey process was a valuable supplement to time-consuming country visits and ultimately provided useful input from a wider cross-section of persons involved in NTD efforts. The suggestions will guide upcoming technical assistance as countries move toward their control and elimination goals.

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