Description
Background
The COVID-19 pandemic had significant impact on health services globally, resulting in neglect of other diseases like malaria. Consequently, efforts and resources were diverted to tackle COVID-19, which resulted in poor adherence to national malaria diagnosis and treatment guidelines in many parts of Nigeria.
Aim
To showcase the effectiveness of innovative behaviour change strategies implemented in Bonny during the pandemic to improve malaria service delivery and outcomes.
Methods
A six-step conceptual model was used to design and implement the pilot intervention. Social Cognitive Theory provided a lens for exploring the complex interplay between behaviour and influencing physical and social environmental factors. A problem analysis/definition (step 1) helped identify specific provider and client behaviours contributing to case management challenges. A behavioural diagnosis (step 2) revealed factors influencing those behaviours to guide intervention design (step 3). Provider and client interviews, facility workflow analysis, data reviews and provider training for behaviour modification was conducted from January-March 2021. The implementation (step 4) spanned from April 2021-May 2022, covering 3 primary and 1 secondary health facilities. Activities included sustainable supply chain for remote communities, facility-driven community outreaches, performance reviews, and establishment of supportive supervision and data quality assessment mechanisms. Community Volunteers were engaged for demand creation.
Findings/Results
At inception (May 2021), adherence to national malaria diagnosis guidelines was 134%, indicating over-testing, wastage of diagnostic test kits and poor data quality. This improved significantly to 100% from July 2021-May 2022. There was no significant change in adherence to treatment guidelines, within the review period as most clients preferred to purchase their medications from external sources after testing positive at the hospital. Malaria-in-pregnancy guidelines adherence was lowest in May 2021 but increased to 93%-100% from July 2021-May 2022. Community Volunteers’ knowledge improved from 61.67% in 2021 to 90.95% in 2022. There was increased facility and community ownership, as well as better service delivery and outcomes performance. Further analysis is being done to review the effect of same behavioural economics principles on community-based services such as traditional birth attendants in provision of malaria chemoprophylaxis and referral of pregnant women for antenatal care.
Conclusion
Overall, this study provides insights on how innovative behaviour change strategies can significantly sustain service delivery in disruptive periods such as a pandemic and prevent a reversal of malaria programme achievements.
| Contact Geneva Health Forum | I would like to receive information about the GHF 2024 conference and other GHF activities / Je souhaite recevoir des informations sur la conférence GHF 2024 et d'autres activités du GHF. |
|---|
