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 (2017-2019).
PAR can strengthen health systems by connecting and co-creating potentially sustainable solutions to implementation challenges. Co-researchers from the Nigerian Federal and State Ministries of Health in Ogun and Kaduna, and local level NTD implementers have been research partners throughout the PAR cycle. This process resulted in the co-creation of evidence-based implementation tools that promote a bottom-up and participatory approach to planning and implementing equitable MAM. These include: A comprehensive Participatory Guide for Planning (PGP) Mass Administration of Medicine (MAM) to tackle NTDs, action planning templates (rural and urban specific), a training video and state-specific ‘Learning Packs’ that review IEC materials and community engagement structures.
The next phase of the research is to scale up the new approach to planning and implementing MAM through application of the tools created during the first PAR cycle. The scale up process will be driven by State working Groups comprised of policy makers and implementers of the NTD programme which were formed to review and advise on effective use of the intervention tools across all relevant contexts for the NTD programme in their states. This research will be evaluated through qualitative and quantitative methods. Learnings from this process will be used to adapt the tools further, and to provide clear guidance on the best ways to scale up the participatory planning and implementation process for more equitable MAM delivery in other states. Alongside this process is a capacity strengthening arm that aims to support health systems strengthening for using more participatory planning and establishing better relational dynamics with communities for sustained learning health systems.