Using the role model approach to optimise caregiver administration of sulfadoxine- pyrimethamine amodiaquine to children aged 3–59 months in Burkina Faso, Chad and Togo: findings from an evaluation

Author:

Donovan Laura1,Shafique Muhammad1,Wharton-Smith Alexandra2,Richardson Sol3,Viganò Erica1,Traore Adama1,Compaoré Cheick1,Tounaikok Narcisse1,Beakgoube Honoré1,Dingamtel Nodjiyam1,Awokou Fantche1,Sewu Essèboè1,Tougri Gauthier4,Diar Mahamat Saleh Issakha4,Atcha-Oubou Tinah4,Ward Charlotte2,Baker Kevin1

Affiliation:

1. Malaria Consortium

2. London School of Hygiene & Tropical Medicine

3. Vanke School of Public Health, Tsinghua University

4. National Malaria Control Program

Abstract

Abstract

Background Seasonal malaria chemoprevention (SMC) is a World Health Organization-recommended intervention for the prevention of malaria among children at high risk in areas with seasonal transmission. During the coronavirus disease 2019 (COVID-19) pandemic, SMC drug distribution was rapidly adapted to reduce contact and mitigate the risk of transmission between communities and community distributors, with caregivers administering doses. To address the challenges and find local solutions to improve administration and adherence, the role model approach was designed, implemented and evaluated in selected communities of Burkina Faso, Chad and Togo. This paper describes the results of this evaluation.Methods Focus group discussions were held with primary caregivers in all three countries to understand their perceptions of the approach’s acceptability and feasibility. In Burkina Faso and Togo, household surveys assessed the characteristics of caregivers reached by role model activities. Key indicators on SMC coverage and adherence allowed for an assessment of caregiver engagement outcomes related to participation in activities. We tested statistical associations between participation in role model activities and caregiver beliefs related to SMC.Results The majority of caregivers believed the approach to have a positive effect on drug administration, with most adopting the promoted strategies. Greater involvement of fathers in drug administration and acknowledgement of their joint responsibility was a notable positive outcome. However, several barriers to participation were noted and there was criticism of the group approach. In Burkina Faso and Togo, end-of-round survey results revealed that 98.4% of respondents agreed the approach improved their knowledge and skills in malaria prevention, while 100% expressed a desire to continue practicing the behaviours learned. However, there was a relatively low level of awareness of the approach among communities. Participation was strongly associated with participants’ self-reported belief in ease of remembering to administer, and ease of administering, SMC medicines.Conclusion Caregivers perceived the role model approach to be beneficial in aiding drug administration, with other positive impacts also reported. Replication and scale-up should utilise the most popular communication channels and existing community structures to ensure activities are promoted effectively. A mixture of group and one-on-one approaches should be used where appropriate and feasible.

Publisher

Springer Science and Business Media LLC

Reference24 articles.

1. WHO Guidelines for malaria - June 2022;World Health Organization;Who,2022

2. Effectiveness of seasonal malaria chemoprevention at scale in west and central Africa: An observational study;ACCESS-SMC Partnership;Lancet,2020

3. Seasonal malaria chemoprevention in the Sahel subregion of Africa: a cost-effectiveness and cost-savings analysis;Gilmartin C;Lancet Glob Health,2021

4. Consortium M. What is seasonal malaria chemoprevention? 2022.

5. Malaria Consortium. Coverage and quality of seasonal malaria chemoprevention supported by Malaria Consortium in 2021: Results from Burkina Faso, Chad, Mozambique, Nigeria, Togo, and Uganda. 2022.

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