Enabling Elimination Supporting governments in developing sustainable national NTD programmes 35 countries Improving the educational achievement of children, especially girls, through national programmes that enhance the health, nutrition and psychosocial status of children in low- and middle-income countries’ School is a ready made platform Laura Appleby, PhD

School is at heart of every community – no matter how basic.

Working with partners to design evidence based programmes Survey data Predictive risk Control planning PCD were involved in 11,000 surveys in Kenya, using maps and empiracle values, which clearly identified three areas for risk and control measures. WFP were deworming in the North, where no requirement, as a result, efforts were refoccused deworming to other areas. Maximising results without cost increase -how mnay teaachers, how many students how many schools and how many pills = define the numbers at risk of infection with each STH and schistosome species determine areas requiring mass treatment and provide estimates of target populations forecast drug needs and costs for albendazole and praziquantel  facilitate efficient allocation of scarce control resources

Integrated SHN in Action The Enhanced School Health Initiative (ESHI) To determine the current situation in terms of SHN in the targeted communities? Activities under this component will include gathering education, health and nutrition, food security and other socio-economic data The maps can be used to:

Overall WASH and deworming: SHN Combined Cost per Child (HGSF, WASH and Deworming) Overall WASH and deworming: $6.68/chd/yr $1.05 in CC and $0.06 in government contribution Deworming: $0.40 per child (drugs were donated) Made up of transport and salary costs First time integrated costs have been measured and analysed This is a ‘real’ cost analysis. Community investment is high: includes: salaries of cooks, security, firewood, materials for construction. Comparable with other programmes. Very little information to compare much of this to, # WASH is a depreciating cost, while SF is a recurring cost Training and awareness is also including IEC materials RE deworming: We are closely engaging with the MoH as they roll out their SB deworming to gather costing data for a more precise estimate of the costs to the government. Overall SF: $28.01/chd/yr Including a $4.16 community contribution and $0.57 Local Government supervision cost   Overall WASH and deworming: $6.68/chd/yr $1.05 in community contribution and $0.06 in government contribution Identifies synergies for integrating these interventions lies in transport (Eg IEC/Drugs and Food), storage and monitoring visits. However, the programme maximises the benefits of the interventions. For example: If implementing SF  deworming will feed the children not the worms. If we are including deworming, WASH will help prevent reinfection rates. Data sources – Three sets of data: The first level of analysis utilised data directly from institutions budgeting processes. The second level of data was collected from structured interviews at a regional and woreda level with programme staff and relevant government bureaus The third level of data was surveying of 25 schools within SNNPR. During surveying the cost to schools/communities, how that cost was paid for (in kind/cash etc) and the frequency of payment were considered. Overall SF: $28.01/chd/yr Including a $4.16 CC & $0.57 Local Government cost   Overall: $35.15 per child per year.

Enabling Elimination Research into Action High level political support Policy and programmatic integration between and within sectors Formulated joint operational plans and programmes Evidence based Contextually adapted Overcome any identified supply chain barriers Allocated budget and resources Capacity building Implement effective M&E Incl community senstitization eg Ghana eg Bihar. Including training Barriers for eg the drugs

Countries need a grand plan of how to operationalize. The school is our primary platform, it is at the heart of the community with Parent involvement Working together this is the strongest operational opportunity to look forward to elimination of STH.

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