1. 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

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

3. 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

4. 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:

5. 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.

6. 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

7. 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.

8. www.imperial.ac.uk/pcd & www.schoolsandhealth.org
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