Microplanning manual to guide implementation of preventive chemotherapy to control and eliminate neglected tropical diseases

Overview: Neglected tropical diseases (NTDs) affect more than 1 billion people globally, causing serious, long-term health effects. Therefore, timely and effective existing interventions reduce morbidity and mortality. The new NTD road map advocates preventive chemotherapy as a core intervention to reduce the burden of NTDs. Preventive chemotherapy is a rapid impact intervention that involves regular administration of safe, effective medicines to a defined population irrespective of its infection status.

While health ministries and partners have made substantial progress against NTDs, the global community has not yet achieved its goals including for preventive chemotherapy to control or eliminate the following NTDs: lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases, trachoma, foodborne trematodiases (fascioliasis, paragonimiasis, clonorchiasis and opisthorchiasis), taeniasis, scabies and other ectoparasitoses, and yaws. To achieve the expected impact of preventive chemotherapy, medicines should be administered to populations who are eligible to receive the intervention (3–7). Annex 1 summarizes the frequency of use of medicines recommended for preventive chemotherapy and the minimum threshold coverage for NTDs amenable to the intervention.

Effective administration of preventive chemotherapy relies largely on operational planning which addresses the need for programs to reach all eligible people and maximize community demand for the intervention. Local, bottom-up planning (“microplanning”) fosters effective implementation and monitoring of public health programs. Originally, public health implementers developed microplanning for use in vaccination campaigns, but various programs, including those for control and elimination of NTDs, now use it. This manual is based on these and other country experiences in microplanning of preventive chemotherapy for NTDs. It describes the basic concepts of microplanning, steps, and examples of tools to develop and implement a microplan.

Since microplanning originates at the lowest level of implementation, and is a bottom-up process, the main target audience of this manual is individuals who are responsible for oversight of preventive chemotherapy against NTDs.  Throughout the manual these individuals are referred to as “first-level supervisors”.  As first-level supervisors are often trained by national program managers or regional/district level supervisors, the manual is also intended for this audience, and provides generic tools, forms and processes that can be adapted to different contexts.  Elements of the manual will also be relevant to others who are involved in microplanning at the community level, such as community leaders, community drug distributors (CDDs), teachers and health communicators. (WHO, 2022)

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