Multimethod evaluation of health services integration for neglected tropical diseases requiring case management in Liberia.

Kollie, Karsor K, Theobald, Sally ORCID: https://orcid.org/0000-0002-9053-211X, Jones, Lent, Kpadeh, Otis, Nallo, Gartee, Borbor, Darwosu, Taylor, Mark ORCID: https://orcid.org/0000-0003-3396-9275, Dean, Laura ORCID: https://orcid.org/0000-0002-4910-9707, Phillip, Maneesh, Godwin-Akpan, Tiawanlyn G, Mensah, Deborah Fulamuso, Wickenden, Anna, Kollie, Jewel T, Rogers, Emerson, Zaizay, Zeela and Stewart, Martyn ORCID: https://orcid.org/0000-0003-1037-7162 (2024) 'Multimethod evaluation of health services integration for neglected tropical diseases requiring case management in Liberia.'. BMJ Global Health, Vol 9, Issue 1, e012599.

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Abstract

Introduction
The WHO neglected tropical disease (NTD) roadmap stresses the importance of integrating NTDs requiring case management (CM) within the health system. The NTDs programme of Liberia is among the first to implement an integrated approach and evaluate its impact.
Methods
A retrospective study of three of five CM-NTD-endemic counties that implemented the integrated approach was compared with cluster-matched counties with non-integrated CM-NTD. We compared trends in CM-NTD integrated versus non-integrated county clusters. We conducted a pre-post comparison of WHO high-level outcomes using data collected during intervention years compared with baseline in control counties. Changes in health outcomes, effect sizes for different diseases and rate ratios with statistically significant differences were determined. Complementary qualitative research explored CM-NTD stakeholders' perceptions, analysed through the framework approach, which is a transparent, multistage approach for qualitative thematic interdisciplinary data analysis.
Results
The detection rates for all diseases combined improved significantly in the intervention compared with the control clusters. Besides leprosy, detection rates improved with large effects, over fourfold increase with statistically significant effects for individual diseases.
Conclusions
Integrating CM-NTDs improves case detection, accessibility and availability of CM-NTD services, promoting universal health coverage. Early case detection and the quality of care need further strengthening.

Item Type:	Article
Subjects:	WA Public Health > Health Administration and Organization > WA 525 General works WA Public Health > Health Administration and Organization > WA 540 National and state health administration WC Communicable Diseases > Tropical and Parasitic Diseases > WC 680 Tropical diseases (General)
Faculty: Department:	Biological Sciences > Department of Tropical Disease Biology Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1136/bmjgh-2023-012599
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	30 Jan 2024 14:41
Last Modified:	30 Jan 2024 14:41
URI:	https://archive.lstmed.ac.uk/id/eprint/23914

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