The use of formative research to inform the design of a seasonal malaria chemoprevention intervention in northern Nigeria

Malaria Journal

Research

Naome Wandera¹  Tanimu Babale²  Madeleine Marasciulo³  Helen Counihan³  John Dada³  Ebenezer Baba³  Maxwell Kolawole³  Sandrine Martin³  Sylvia R. Meek³  Prudence Hamade³  Musa Kana⁴  Clare E. Strachan⁵ 

[1] Inspire Sustainable Development Agency, Baden Powel House, Buganda Road, Kampala, Uganda;Katsina State Ministry of Health, State Secretariat Complex, IBB Way, Katsina, Nigeria;Malaria Consortium, Development House, 56-64 Leonard Street, EC2A 4LT, London, UK;Malaria Consortium, Development House, 56-64 Leonard Street, EC2A 4LT, London, UK;Department of Community Medicine, Kaduna State University, Kaduna, Nigeria;EPI Unit, Institute of Public Health, University of Porto, Porto, Portugal;Malaria Consortium, Development House, 56-64 Leonard Street, EC2A 4LT, London, UK;London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK;

关键词: Community perceptions;    Drug delivery;    Formative research;    Intervention design;    Malaria;    Nigeria;    Preventive treatment;    Qualitative;    Seasonal malaria chemoprevention;   

DOI  :  10.1186/s12936-016-1526-9

 received in 2016-04-20, accepted in 2016-09-07,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundExperience of seasonal malaria chemoprevention (SMC) is growing in the Sahel sub-region of Africa, though there remains insufficient evidence to recommend a standard deployment strategy. In 2012, a project was initiated in Katsina state, northern Nigeria, to design an appropriate and effective community-based delivery approach for SMC, in consultation with local stakeholders. Formative research (FR) was conducted locally to explore the potential feasibility and acceptability of SMC and to highlight information gaps and practical considerations to inform the intervention design.MethodsThe FR adopted qualitative methods; 36 in-depth interviews and 18 focus group discussions were conducted across 13 target groups active across the health system and within the community. Analysis followed the ‘framework’ approach. The process for incorporating the FR results into the project design was iterative which was initiated by a week-long ‘intervention design’ workshop with relevant stakeholders.ResultsThe FR highlighted both supportive and hindering factors to be considered in the intervention design. Malaria control was identified as a community priority, the community health workers were a trusted resource and the local leadership exerted strong influence over household decisions. However, there were perceived challenges with quality of care at both community and health facility levels, referral linkage and supportive supervision were weak, literacy levels lower than anticipated and there was the potential for suspicion of ‘outside’ interventions. There was broad consensus across target groups that community-based SMC drug delivery would better enable a high coverage of beneficiaries and potentially garner wider community support. A mixed approach was recommended, including both community fixed-point and household-to-household SMC delivery. The FR findings were used to inform the overall distribution strategy, mechanisms for integration into the health system, capacity building and training approaches, supportive interventions to strengthen the health system, and the social mobilization strategy.ConclusionsFormative research played a valuable role in exploring local socio-cultural contexts and health system realities. Both opportunities and challenges for the introduction of SMC delivery were highlighted, which were appropriately considered in the design of the project.

【 授权许可】

CC BY   
© The Author(s) 2016