SGLK13025U Mass drug administration in low-income countries

Volume 2015/2016
Education

MSc in Global Health

The summer course is relevant to both MSc and PhD students in public health science, global health, medicine, and anthropology as well as others working within and with health and health systems.

Content

The administration of drugs to whole populations is referred to as mass drug administration (MDA). Presently, MDA is primarily applied for control of parasitic infections, which involves administering drugs to entire endemic populations regardless of individuals’ infection status. MDA has now been implemented in more than 50 countries worldwide targeting parasitic infections such as hookworms, ascariasis, trichuriasis, schistosomiasis and lymphatic filariasis. Recently, malaria has been added to one of the potential target infections. In order to achieve the MDA goal of elimination of various parasitic infections as a public health problem, it is crucial that a major proportion in the target community adhere to the drug regimen during the prescribed period. A minimum adherence rate, for which the intervention is considered effective, is commonly considered to be 65-85%. However, studies from MDA programmes in different parts of the world indicate that drug uptake rates are often much lower. This summer course will focus on the conceptual outlines of MDA and on the many challenges in reaching a high drug uptake rate. In addition, the course will be of relevance for public health programmes, which make use of mass-intervention approaches, e.g. mass vaccination campaigns and mass screening for infectious and non-communicable chronic diseases.

The course will focus on the following cross-disciplinary aspects of MDA:

a) Overall concept of MDA;

b) MDA in relation to control of hookworms, ascariasis, trichuriasis, schistosomiasis, lymphatic filariasis and malaria;

c) Drug combinations and treatment cycles;

d) Planning and implementation of MDA activities in rural and urban settings, including community- and non-community based drug distribution strategies and programme promotion;

e) Drug uptake rates, including modelling and systematic and random drug uptake patterns;

f) Provider- and population-related factors influencing drug uptake;

g) Ethical aspects of MDA;

h) WHO’s Model for Health System Assessment as a tool for ensuring quality and optimizing drug uptake in MDA; and

i) Applied qualitative and quantitative assessment methods for monitoring and optimizing drug uptake in MDA;

j) How to translate the MDA experience to other mass treatment scenarios, and to assure quality of and evidence for present and future MDA.

Learning Outcome

After completing the course, the participant will have acquired the following knowledge, which will allow the participant to:

  • Explain the lifecycle and public health importance of the most common target infections of relevance for MDA
  • Explain the basic principles and concepts in MDA in relation to drug combinations, planning, implementation, and interaction between providers and target populations and effects of intervention
  • Describe the various possibilities and barriers related to implementation of MDA with specific focus on how community members perceive the intervention
  • Reflect on the advantages and disadvantages of community- and non-community based drug distribution strategies

 

After completing the course, the participant will have acquired the following skills, which will allow the participant to:

  • Measure drug uptake rates in order to evaluate MDA outcomes
  • Allow interpretation of reports and scientific publications which describe MDA in order to suggest possible improvements and measures which will lead to increased drug uptake rates in a given scenario
  • Develop and use appropriate cross-disciplinary research methods to collect, analyze and evaluate MDA interventions from both provider and population perspectives in order to increase drug uptake rates

 

After completing the course, the participant will have acquired the following competencies, which will allow the participant to:

  • Translate theories and principles of health system research to implementation of MDA
  • Work independently to perform an evidence based situational analysis with the aim of identifying modifiable factors which can increase drug uptake rates in a given MDA scenario
  • Participate in a professional team where results obtained from cross-disciplinary research approaches will be used to optimize implementation and sustainability of MDA activities
Literature

On-line lectures, on-line videos and on-line exercises, including automatically assessed multiple choice quizzes, online based discussions and individual assignments. Lectures, policy papers, reports, scientific publications.  

All students are required to follow and participate in all online activities and to submit the required written assigments.
A background in anthropology, public health, medical sciences. The course requires oral and written academic English skills and basic knowledge regarding the use of qualitative and quanitative research methods.
This is a 7.5 ECTS, 5-week diploma course. There are no class-based teachings during this course, and it can be done entirely as distance learning. The first 3 weeks are held as an on-line/e-learning course with on-line lectures, videos and exercises, including automatically assessed multiple choice quizzes and online discussions. The subsequent 2 weeks of the online course are held with an extensive focus on written assignments, case work, journal clubs, online workshops and online discussions.
  • Category
  • Hours
  • Course Preparation
  • 24
  • E-Learning
  • 40
  • Exam
  • 40
  • Exercises
  • 62
  • Preparation
  • 40
  • Total
  • 206
Credit
7,5 ECTS
Type of assessment
Written assignment, 72 hours
The exam will be based on a written report submitted in the end of 5-week course.
Aid
All aids allowed
Marking scale
passed/not passed
Censorship form
No external censorship
Exam period

The exam will be based on a written report submitted in the end the course.

Re-exam

Course participants who fail the first examination will be offered a subsequent re-examination.

Criteria for exam assesment

After completing the course, the participant will be evaluated according to the following acquired knowledge. The ability to:

  • Explain the lifecycle and public health importance of the most common target infections of relevance for MDA
  • Explain the basic principles and concepts in MDA in relation to drug combinations, planning, implementation, and interaction between providers and target populations and effects of intervention
  • Describe the various possibilities and barriers related to implementation of MDA with specific focus on how community members perceive the intervention
  • Reflect on the advantages and disadvantages of community- and non-community based drug distribution strategies

 

After completing the course, the participant will be evaluated according to the following acquired skills. The ability to:

  • Measure drug uptake rates in order to evaluate MDA outcomes
  • Allow interpretation of reports and scientific publications which describe  MDA in order to suggest possible improvements and measures which will lead to increased drug uptake rates in a given scenario
  • Develop and use appropriate cross-disciplinary research methods to collect, analyze and evaluate MDA interventions from both provider and population perspectives in order to increase drug uptake rates

 

After completing the course, the participant will be evaluated according to the following acquired competencies. The ability to:

  • Translate theories and principles of health system research to implementation of MDA
  • Work independently to perform an evidence based situational analysis with the aim of identifying modifiable factors which can increase drug uptake rates in a given MDA scenario
  • Participate in a professional team where results obtained from cross-disciplinary research approaches will be used to optimize implementation and sustainability of MDA activities