How participatory research is helping to tackle neglected tropical diseases

COUNTDOWN is a research project set in four African countries: Nigeria, Liberia, Cameroon and Ghana.

Sightsavers is a collaborating partner in the Nigeria programme, in partnership with Liverpool School of Tropical Medicine and the Federal Ministry of Health.

The project is dedicated to finding a cost-effective way to scale up the sustainable solutions to control and eliminate the seven most common neglected tropical diseases (NTDs) by 2020.

A recent situation analysis in Nigeria showed us that we need to engage with communities better if we want the mass administration of NTD medicines to continue making gains and sustain those it has already made. We have been supporting the programme to gather the practical knowledge and experience of the communities, implementers and programme managers, and use it to collectively find solutions, implement changes and evaluate them.

Over the past year, the research team (including NTD programme implementers) has mapped key community landmarks and gathering points from the perspective of young and older women, men and community leaders. The team has also trialled the use of materials including posters, flipcharts and handouts to sensitise community members about NTD programmes. We have run feedback sessions on these materials and on mock training cascades (where each group of people trained on mass administration of medicines trains the group after them). Together with programme implementers, we have reflected on the findings to create and implement solutions in the Nigeria NTD programmes.

Participation is the defining principle throughout this cycle; we ensured the inclusion of researchers from a variety of disciplines, and stakeholders and marginalised groups who often don’t have input on decisions that affect them, particularly women, children and community-directed distributors. The use of participatory research methods (where research is reliant on and defined by the people participating) helps ensure that finding and solving programme bottlenecks is carried out equitably rather than by a few individuals, leading to greater ownership of decisions throughout the whole programme. This approach of using participatory methods to gather and analyse information, and then reflect and make change based on practical knowledge and experience, is known as a participatory action research (PAR) cycle.

In Nigeria, this approach will not only contribute to conceptualising and developing a clear community engagement plan to advance NTD programme planning, but will also lead to strengthening the skills and processes of planners and implementers.

Power imbalances between programme implementers and donors in planning processes are redressed when PAR is used. It also allows for ongoing modifications to be made to programme delivery, based on the tacit knowledge and understandings of programme implementers, with a view to embedding sustainable change. Participatory approaches have advanced collaboration and partnerships across different sectors, combatting some of the traditional challenges in making progress towards the global Sustainable Development Goals.

The COUNTDOWN team in Nigeria is led by the Federal Ministry of Health (FMOH) and includes social scientists, health economists, a research uptake officer (embedded in FMOH), and a research manager/officer.

Find out more details on the project and on PAR on the COUNTDOWN website.

Authors

Ruth Dixon and Luret Lar
Ruth is Sightsavers’ Technical Adviser for NTD research. Luret is Sightsavers’ Research Manager for the COUNTDOWN project.