The overall purpose of this study is:
‘To facilitate effective community engagement through adaptive use of community structures to contribute toward NTD elimination in Ogun and Kaduna states in Nigeria.’
The first stage of COUNTDOWN research in Nigeria was a situational analysis, which sought to document the current strengths and weaknesses of the NTD programme, specifically in Ogun and Kaduna States, with a view to identifying areas for future implementation research. Within this situational analysis, it was identified that across both States, the NTD programme is currently facing significant challenges in adapting a once very successful community engagement strategy to suit the changing needs of rural communities, as well as the needs of populations living in varying and emerging contexts e.g. urban, border, migrant populations.
COUNTDOWN’s situational analysis revealed several challenges to the CDI (community-directed intervention) approach that need to be addressed to ensure successful long-term community engagement with the NTD programme in Nigeria. These challenges included: competing community development needs such as provision of safe drinking water, food etc.; steady decline in visible morbidity associated with NTDs meaning communities no longer perceive a need for, or an intrinsic benefit of the NTD programme; weak community mobilisation and sensitisation activities; improper training management of drug side effects leading to drug refusal; and other disrupting factors such as community fatigue, religious and spiritual beliefs, alternate community structures, and disengagement of community volunteers due to a lack of remuneration from the NTD programme.
Our research in Nigeria is broken down into four phases.
Phase One: Assessing the range of community structures and current engagement strategies. This will be a Participatory Exploratory research which will explore and leverage community structures whilst understanding and adapting existing NTD educational materials.
Phase Two: Development of a package of enhanced community engagement strategies. This will involve participatory analysis and action planning with frontline NTD implementers at the state, LGA and community level using some synthesis of evidence to develop alternative community engagement strategies.
Phase Three: Implementing and evaluating the effectiveness and inclusiveness of enhanced community engagement packages. This strand of work will be done in conjunction with the health economics team. It will involve cost-effectiveness analysis and implementation and evaluation using an action research cycle.
Phase Four: Recommendations for what works best for community engagement with the NTD programme in Ogun and Kaduna States in Nigeria.
SITES OF STUDY
Ogun State: Yewa North LGA (local government area), Ijebu East LGA and Obafemi Owode LGA
Kaduna State: Jema’a, Kagarko and Kubau local government areas