Health Campaign Integration: A Scoping Review

Research Project

A literature review of integrated campaigns that prevent and control neglected tropical diseases (NTDs)

Photo credit: Leeshia Crayton for ITI, Task Force for Global Health

Summary

A review that summarizes the available literature on the economic and social benefits resulting from health campaign integration, with a focus on NTDs.

Sub-Saharan Africa

Most studies were conducted in sub-Saharan Africa.

Neglected Tropical Diseases (NTDs)

Promising Practices

NTD campaigns, particularly MDA campaigns, should be integrated with other health campaigns or into the health system.
Include local context, local leadership, community involvement, and health education in the development and delivery of integrated campaigns.

Key Messages

The Rollins School of Public Health at Emory University examined peer-reviewed literature on integrated campaigns that include strategies to prevent and control neglected tropical diseases (NTDs). Findings include:

Strong evidence of infection reduction and cost effectiveness supports campaign integration.
Strong evidence indicates there are no severe adverse events (i.e., mortality or systemic allergic reactions) following the administration of the multiple drugs delivered in integrated campaigns; however, qualitative data suggests participant perception of adverse events including, but not limited to, stomach aches, and vomiting may interfere with chemoprophylaxis uptake.
The inclusion of health education as a component of program implementation contributes to improved uptake and is supported by moderate evidence.
Consideration of local context improves cost effectiveness and is supported by strong evidence.
Future research can be conducted to add quantitative data to the existing qualitative data on participant cost and time savings and elucidate campaign volunteer experience with and perceptions of per diem across campaigns.

Background

Context and Objective

Campaign integration, or the co-delivery of interventions, is expected to save cost and time, streamline operations, and increase benefits for the participant; however, the landscape of the total balance of social and economic benefits and harms in the peer-reviewed literature is unknown. To fill this gap in knowledge, the team at the Rollins School of Public Health conducted a scoping review.

Objective
To identify and aggregate the best available evidence on the economic and social benefits and resulting from the integration of health programs into other health programs or into country healthcare systems in low- and middle-income countries, and to develop promising practices that can be implemented by governments, policy makers, and programs.

Research Question

What is the balance of economic and social benefits and harms resulting from health campaign integration for community members and leaders, health campaign and healthcare workers, healthcare systems, country leadership, donors, and the private sector?

View the slides and research brief for detail on the research methods.

Results

Summary

NTD health campaigns, particularly mass drug administration campaigns, should be integrated with other health campaigns, or into the health system.

This is supported by strong evidence of both infection reduction in participant populations and cost effectiveness for governments and programs with the integration of health campaigns. This is further supported by moderate and emerging yet consistent qualitative evidence of time and economic benefits for participants, relationship strengthening, and increases in equitable distribution.

Programs should incorporate health education in the development and delivery of these campaigns.

This is supported by moderate and emerging evidence on the importance of health education in the uptake of integrated NTD MDA programs and understanding of the adverse events and side effects that accompany the drugs. The importance of health education was supported by health campaign personnel and participants.

Programs should consider local context when selecting the delivery channel for PC NTD health campaigns.

This is supported by strong cost effectiveness data indicating MDA only campaigns were more cost effective when delivered via community or combined community and school delivery channels compared to school alone.

Outcomes with strong evidence

Outcome	Strength [Evidence]	Direction	Results	Conclusion
Decrease in NTD Infection	Strong [14 studies(1-14)]	Consistent	Most studies demonstrated a decrease in the prevalence of at least one NTD	Supports integration
Cost Effectiveness	Strong [16 studies(1, 6, 16, 25-28, 30-39)]	Consistent	MDA only campaigns were more cost effective in the community or combined community and school delivery channels. Cost effectiveness studies reporting on integration examined MDA the context of multiple health interventions, or a one-health approach integrated campaigns were more cost effective	Supports integration and consideration of health interventions in the local context

View the slides for other themes and outcomes.

NTD campaigns, particularly MDA campaigns, should be integrated with other health campaigns or into the health system.
Include local context, local leadership, community involvement, and health education in the development and delivery of integrated campaigns.

Research Project