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Seasonal Malaria Chemoprevention in Nigeria: Coverage Surveys 2017

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Seasonal Malaria Chemoprevention in Nigeria: Coverage Surveys 2017 Seasonal Malaria Chemoprevention in Nigeria: Coverage surveys 2017 Report compiled by Paul Milligan, London School of Hygiene & Tropical Medicine Citation: P Milligan, M Kana, S Lal, P Snell (2018) Seasonal Malaria Chemoprevention in Nigeria: Coverage surveys 2017. Acknowledgments: D Moroso, A Roca, Malaria Consortium Page 1 of 50 Contents Summary of findings ............................................................................................................................... 5 Background ......................................................................................................................................... 5 Percentage of children who received SMC ......................................................................................... 5 Results for cycle 1 ............................................................................................................................... 6 Results for cycles 2, 3 and 4 ................................................................................................................ 6 Awareness of the dates of SMC campaigns ........................................................................................ 6 Equitability of SMC distribution .......................................................................................................... 6 Caregiver’s understanding of SMC ...................................................................................................... 7 Adherence of CHWs to guidelines for SMC administration, as reported by caregivers ..................... 7 Use of insecticide-treated bednets in SMC distribution areas at cycle 4 ........................................... 7 Population changes ............................................................................................................................. 7 Quality control .................................................................................................................................... 7 Recommendations .............................................................................................................................. 8 Background ........................................................................................................................................... 10 Seasonal Malaria Chemoprevention ..................................................................................................... 11 Survey methods .................................................................................................................................... 12 Training, piloting and data collection ............................................................................................... 16 Composition of field teams ............................................................................................................... 17 Training ............................................................................................................................................. 17 Supervision arrangements and quality control................................................................................. 17 Detailed results ..................................................................................................................................... 18 Comparison of coverage estimates for cycles 1-3 from the final survey with the estimates after each cycle .......................................................................................................................................... 21 Results for Cycle 1 survey ..................................................................................................................... 22 Results for Cycle 2 ................................................................................................................................. 26 Results for Cycle 3 ................................................................................................................................. 28 Results for final survey .......................................................................................................................... 30 Annex .................................................................................................................................................... 41 A1. Quality control ............................................................................................................................ 41 Repeat interviews ......................................................................................................................... 41 Comparison of data captured from cards with card images ........................................................ 42 A2: Sampling methods ...................................................................................................................... 43 Page 2 of 50 Figure 1: Timing of SMC distribution and surveys in 2017 Figure 2: Location of survey clusters in Sokoto, Zamfara, Katsina and Jigawa Figure 3: Location of the survey area in Nigeria Figure 4: Key steps in the survey process Figure 5: Images of SMC cards are uploaded and incorporated in the Access database for comparison with the data from the card captured by the field worker Figure 6: SMC coverage is associated with the percentage of households aware of the date of SMC in advance Figure 7: Map showing coverage of SMC at cycle 1 (% eligible children treated), per LGA Figure 8: Map showing % of treatments Directly Observed Therapy at cycle 1, per LGA Figure 9: Reliability of the coverage per cycle estimated in the final survey Figure 10: Awareness about the SMC campaign dates: proportion of households that heard the dates and the source of information (cycle 1) Figure 11: Awareness about SMC campagn dates, cycle 2 Figure 12: Public awareness about SMC, and about the dates of the most recent SMC campaign (cycle 4), and where caregivers heard about date of the campaign Figure 13: Wealth ranking of households, by state Table 1: Population indicators and malaria prevalence in the regions of Nigeria Table 2: Prevalence of malaria in children in 2015 in North-West Region Table 3: Dates of SMC distribution in 2017 and dates of coverage surveys Table 4: Summary of results from the four surveys (all states combined) Table 5: Summary of results from the four surveys, for Jigawa and Katsina, Sokoto and Zamfara Table 6: Comparison of coverage estimates after each cycle with those from the final survey Table 7: Coverage and adherence among eligible children aged 3-59 months (Cycle 1) Table 8: Supervision of the first dose in cycle 1 Table 9: Treatment in children older than 59 months at cycle 1 Table 10: Coverage by LGA, cycle 1 Table 11: Reasons for missed treatments (cycle 1) Table 12: Coverage of SMC in older children (cycle 2) Table 13: Coverage of SMC amongst eligible children by LGA (Cycle 2) Table 14: Coverage of SMC Amongst eligible children by LGA, cycle 3 Table 15: Reasons for missed treatments at cycle 3 Table 16: Final survey response rates and the number of households, children and other household members surveyed Table 17: Percentage of households that were aware of the SMC programme, had heard the date when cycle 4 would start in their village, and the source of the information Table 18: Caregivers’ knowledge scores on SMC Table 19: CHW adherence to guidelines Table 20: Mean caregivers’ knowledge scores, and CHW practice scores Table 21: Percentage of children who were definitely eligible at cycle 4 (aged 3-59 months), who received SMC, and of those who received SMC, the percentage who received all 3 daily doses Table 22: Out of those who received SMC at cycle 4, the percentage whose first dose was administered by the CHW, the percentage that received the second dose, and the percentage that received the third dose Table 23: Reasons for not receiving SMC at cycle 4 Table 24: Reasons for not administering doses 2 and 3 at cycle 4 Table 25: Primary caregiver present at SMC administration Table 26: Time caregiver spent waiting for SMC Table 27: SMC coverage among children eligible for four treatments, by state Table 28: SMC coverage among children eligible for four treatments, by socioeconomic ranking Table 29: Mean coverage over the 4 cycles, percentage received 4 treatments, and percentage who did not receive SMC, by wealth ranking in each state Table 30: SMC coverage among children eligible for four treatments, by gender Table 31: Number of SMC treatments: percentage of children who received SMC 0,1,2,3,or 4 times Table 32: Percentage of children by SMC cycles received Table 33: Treatment of children above the age limit for SMC (aged 6-7 years at the survey) Page 3 of 50 Table 34: Percentage of eligible children who received an SMC card, and the percentage with a card available for inspection during the survey Table 35: Agreement between caregiver report and SMC card Table 36: Percentage of children 3-59months who slept under a bednet (of any type) the night before the survey Table 37: Percentage of household members who slept under a bednet, out of those who slept in the household the night before the survey, by state Table 38: Percentage who slept under a bednet, out of those who slept in the household the night before the survey, by age group Table 39: Percentage who slept under a bednet, out of those who slept in the household the night before the survey, by wealth ranking Table 40: Percentage who slept under a bednet, out of those who slept in the household the night before the survey, by gender Table 41: Percentage of the
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