Findings from a research study conducted by Malaria Consortium to improve the integration of neglected tropical disease (NTD) services into primary health care in Ethiopia show improvements in the ability of primary health care to detect , managing and recording NTDs as well as increased awareness and better integration of NTDs more generally in primary health care settings.

NTDs – the collective name for a group of parasitic and bacterial infectious diseases – affect up to one and a half billion people worldwide, with 40% of cases occurring in sub-Saharan Africa. They have a disproportionate impact on the most vulnerable and marginalized communities and limit the economic and social potential of those affected.

To date, global NTD interventions have primarily focused on mass drug administration. The most recent World Health Organization NTD Roadmap (2021-2030), however, calls for greater integration and integration of NTD approaches into national health systems; more coordinated intersectoral action; and other operational and implementation research, including community-based and applied research.

Ethiopia has one of the highest NTD burdens in Africa. To help the Ethiopian government address this issue and achieve the strategic objectives outlined in the Ethiopian NTD Map, Malaria Consortium undertook a research study to explore the feasibility, acceptability and cost-effectiveness of integrating prevention interventions , diagnosis, management and reporting of three common NTD interventions – lymphatic filariasis, schistosomiasis and trachoma – in the Ethiopian primary health care system, with a similar podoconiosis study also being implemented simultaneously.

“This study, led by Malaria Consortium, adds value to our MTN program, the evidence that has been generated from this endeavor will inform MTN strategies not only in the SNNPR but also in other regions and we are committed to forward the recommendations to the appropriate next steps,” said Mr. Fikre Seif, National NTD Program Team Leader, Ethiopian Federal Ministry of Health

The study took place between December 2019 and January 2022 in Damot Gale, Wolaita Zone, Southern Nations, Nationalities and Peoples’ Region (SNNPR) at one main hospital, one health center and five health posts. health. After initial assessments to determine current health system capacity, service delivery and care-seeking behavior for NTDs, a number of activities were implemented, including: job aids for staff at different levels of the primary health care system; create clear and harmonized NTD case definitions with additional indicators for targeted NTD suspect cases; introduction of sensitive tests for the detection of intestinal schistosomiasis; the provision of drugs and medical supplies to facilitate routine case management; inclusion of the NTD supervision tool in routine supervision; integrated guide for NTD training facilitators and training of health workers.

Data collected on target NTDs before and after the intervention showed improvements in primary health care capacity to detect, manage and record NTDs, increased awareness and better integration of NTDs more generally in health care settings and significant improvements in the use of response materials by health workers and health extension workers as planned with patients and caregivers satisfied with the health service provided.

Key stakeholders, including representatives from the Ethiopian Ministry of Health, recently met to hear the full findings of the study and to discuss recommendations and next steps.

Dr Kevin Baker, Senior Research Advisor at Malaria Consortium, said: “Given the significant and encouraging results of our study, with improved care-seeking behaviors demonstrated for NTDs in primary health care units in Ethiopia , we would seek to further test our intervention in a large-scale implementation evaluation as the next step before scaling up.”