Facilitators and barriers to seasonal malaria chemoprevention (SMC) uptake in Nigeria: a qualitative approach
Abstract Background SMC was adopted in Nigeria in 2014 and by 2021 was being implemented in 18 states, over four months between June and October by 143000 community drug distributors (CDDs) to a target population of 23million children. Further expansion of SMC is planned, extending to 21 states with...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-04-01
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| Series: | Malaria Journal |
| Online Access: | https://doi.org/10.1186/s12936-023-04547-w |
| _version_ | 1797846074718683136 |
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| author | Nnenna Ogbulafor Perpetua Uhomoibhi Emmanuel Shekarau Jamilu Nikau Chukwu Okoronkwo Nadia M. L. Fanou Ibrahima Marietou Mbaye Jean-Louis Ndiaye Andre-Marie Tchouatieu Abena Poku-Awuku Corinne Merle Susana Scott Paul Milligan Aminu Ali Hauwa’u Evelyn Yusuf Stephen Oguche Tukur Dahiru |
| author_facet | Nnenna Ogbulafor Perpetua Uhomoibhi Emmanuel Shekarau Jamilu Nikau Chukwu Okoronkwo Nadia M. L. Fanou Ibrahima Marietou Mbaye Jean-Louis Ndiaye Andre-Marie Tchouatieu Abena Poku-Awuku Corinne Merle Susana Scott Paul Milligan Aminu Ali Hauwa’u Evelyn Yusuf Stephen Oguche Tukur Dahiru |
| author_sort | Nnenna Ogbulafor |
| collection | DOAJ |
| description | Abstract Background SMC was adopted in Nigeria in 2014 and by 2021 was being implemented in 18 states, over four months between June and October by 143000 community drug distributors (CDDs) to a target population of 23million children. Further expansion of SMC is planned, extending to 21 states with four or five monthly cycles. In view of this massive scale-up, the National Malaria Elimination Programme undertook qualitative research in five states shortly after the 2021 campaign to understand community attitudes to SMC so that these perspectives inform future planning of SMC delivery in Nigeria. Methods In 20 wards representing urban and rural areas with low and high SMC coverage in five states, focus group discussions were held with caregivers, and in-depth interviews conducted with community leaders and community drug distributors. Interviews were also held with local government area and State malaria focal persons and at national level with the NMEP coordinator, and representatives of partners working on SMC in Nigeria. Interviews were recorded and transcribed, those in local languages translated into English, and transcripts analysed using NVivo software. Results In total, 84 focus groups and 106 interviews were completed. Malaria was seen as a major health concern, SMC was widely accepted as a key preventive measure, and community drug distributors (CDDs) were generally trusted. Caregivers preferred SMC delivered door-to-door to the fixed-point approach, because it allowed them to continue daily tasks, and allowed time for the CDD to answer questions. Barriers to SMC uptake included perceived side-effects of SMC drugs, a lack of understanding of the purpose of SMC, mistrust and suspicions that medicines provided free may be unsafe or ineffective, and local shortages of drugs. Conclusions Recommendations from this study were shared with all community drug distributors and others involved in SMC campaigns during cascade training in 2022, including the need to strengthen communication about the safety and effectiveness of SMC, recruiting distributors from the local community, greater involvement of state and national level pharmacovigilance coordinators, and stricter adherence to the planned medicine allocations to avoid local shortages. The findings reinforce the importance of retaining door-to-door delivery of SMC. |
| first_indexed | 2024-04-09T17:49:06Z |
| format | Article |
| id | doaj.art-4349892f7c2d4bcc9fcac3efd6e0bfdc |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-04-09T17:49:06Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-4349892f7c2d4bcc9fcac3efd6e0bfdc2023-04-16T11:07:23ZengBMCMalaria Journal1475-28752023-04-0122111310.1186/s12936-023-04547-wFacilitators and barriers to seasonal malaria chemoprevention (SMC) uptake in Nigeria: a qualitative approachNnenna Ogbulafor0Perpetua Uhomoibhi1Emmanuel Shekarau2Jamilu Nikau3Chukwu Okoronkwo4Nadia M. L. Fanou5Ibrahima Marietou Mbaye6Jean-Louis Ndiaye7Andre-Marie Tchouatieu8Abena Poku-Awuku9Corinne Merle10Susana Scott11Paul Milligan12Aminu Ali13Hauwa’u Evelyn Yusuf14Stephen Oguche15Tukur Dahiru16National Malaria Elimination Programme (NMEP)National Malaria Elimination Programme (NMEP)National Malaria Elimination Programme (NMEP)National Malaria Elimination Programme (NMEP)National Malaria Elimination Programme (NMEP)University of Abomey-Calavi, (UAC)Université de Thiès, (UoT)Université de Thiès, (UoT)Medicines for Malaria Venture (MMV)Medicines for Malaria Venture (MMV)TDRLondon School of Hygiene & Tropical MedicineLondon School of Hygiene & Tropical MedicineDept of Sociology, Bayero University of KanoDepartment of Sociology, Kaduna State UniversityDept of Paediatrics, University of JosDept of Community Medicine, Ahmadu Bello UniversityAbstract Background SMC was adopted in Nigeria in 2014 and by 2021 was being implemented in 18 states, over four months between June and October by 143000 community drug distributors (CDDs) to a target population of 23million children. Further expansion of SMC is planned, extending to 21 states with four or five monthly cycles. In view of this massive scale-up, the National Malaria Elimination Programme undertook qualitative research in five states shortly after the 2021 campaign to understand community attitudes to SMC so that these perspectives inform future planning of SMC delivery in Nigeria. Methods In 20 wards representing urban and rural areas with low and high SMC coverage in five states, focus group discussions were held with caregivers, and in-depth interviews conducted with community leaders and community drug distributors. Interviews were also held with local government area and State malaria focal persons and at national level with the NMEP coordinator, and representatives of partners working on SMC in Nigeria. Interviews were recorded and transcribed, those in local languages translated into English, and transcripts analysed using NVivo software. Results In total, 84 focus groups and 106 interviews were completed. Malaria was seen as a major health concern, SMC was widely accepted as a key preventive measure, and community drug distributors (CDDs) were generally trusted. Caregivers preferred SMC delivered door-to-door to the fixed-point approach, because it allowed them to continue daily tasks, and allowed time for the CDD to answer questions. Barriers to SMC uptake included perceived side-effects of SMC drugs, a lack of understanding of the purpose of SMC, mistrust and suspicions that medicines provided free may be unsafe or ineffective, and local shortages of drugs. Conclusions Recommendations from this study were shared with all community drug distributors and others involved in SMC campaigns during cascade training in 2022, including the need to strengthen communication about the safety and effectiveness of SMC, recruiting distributors from the local community, greater involvement of state and national level pharmacovigilance coordinators, and stricter adherence to the planned medicine allocations to avoid local shortages. The findings reinforce the importance of retaining door-to-door delivery of SMC.https://doi.org/10.1186/s12936-023-04547-w |
| spellingShingle | Nnenna Ogbulafor Perpetua Uhomoibhi Emmanuel Shekarau Jamilu Nikau Chukwu Okoronkwo Nadia M. L. Fanou Ibrahima Marietou Mbaye Jean-Louis Ndiaye Andre-Marie Tchouatieu Abena Poku-Awuku Corinne Merle Susana Scott Paul Milligan Aminu Ali Hauwa’u Evelyn Yusuf Stephen Oguche Tukur Dahiru Facilitators and barriers to seasonal malaria chemoprevention (SMC) uptake in Nigeria: a qualitative approach Malaria Journal |
| title | Facilitators and barriers to seasonal malaria chemoprevention (SMC) uptake in Nigeria: a qualitative approach |
| title_full | Facilitators and barriers to seasonal malaria chemoprevention (SMC) uptake in Nigeria: a qualitative approach |
| title_fullStr | Facilitators and barriers to seasonal malaria chemoprevention (SMC) uptake in Nigeria: a qualitative approach |
| title_full_unstemmed | Facilitators and barriers to seasonal malaria chemoprevention (SMC) uptake in Nigeria: a qualitative approach |
| title_short | Facilitators and barriers to seasonal malaria chemoprevention (SMC) uptake in Nigeria: a qualitative approach |
| title_sort | facilitators and barriers to seasonal malaria chemoprevention smc uptake in nigeria a qualitative approach |
| url | https://doi.org/10.1186/s12936-023-04547-w |
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