Monitoring & Evaluation studies for end-line evaluation of KalaCORE
As we are approaching the end of the programme, KalaCORE’s Monitoring & evaluation taskforce (based at the London School of Hygiene and Tropical Medicine) have been conducting end-line evaluation studies. Together with base-line studies which were conducted earlier in the programme, end-line studies will help understand the impact and effectiveness of control and elimination activities during KalaCORE in each of the 6 VL-endemic countries of focus.
We anticipate a range of important insights from these studies.
The team are bringing qualitative and quantitative data together from the studies presented in the Table below. More information for the types of studies is also listed below.
Table: KalaCORE M&E end-line studies per country.
Types of studies
Endline patient survey: To evaluate the treatment seeking practices, diagnosis and treatments received, and household economic burden of VL in endemic areas of Ethiopia, Sudan and India pre and post implementation of KalaCORE interventions.
Theory of Change (ToC): To evaluate the contribution of the KalaCORE programme to reducing the health and economic impact of VL in Bangladesh, Nepal, India, Ethiopia, South Sudan and Sudan using a Theory of Change (ToC) approach.
- Desk review: constructing individual country ToC and populating them with data from secondary analyses to identify successes and bottlenecks;
- Stakeholders interview: investigating the drivers of success, bottlenecks, and the influence of contextual factors using in-depth interviews
Extension studies: to explore further the VL post-treatment economic burden from a household perspective, and to gain a better understanding of the health seeking behaviour and drivers of accrual of costs.
- Pathway to treatment: To gain deeper understanding of VL patients and health providers knowledge and health seeking behaviour choices
- Long term VL patient follow-up: To assess the physical and economic burden of VL approximately six months after treatment and to explore the availability and potential impact of a government compensation on alleviating catastrophic economic costs for patients.
Barriers to access to visceral leishmaniasis diagnosis and care among seasonal mobile workers in Western Tigray, Northern Ethiopia: A qualitative study
"Ethiopia bears a high burden of visceral leishmaniasis (VL)—a neglected tropical disease transmitted through the bite of a sand fly that disproportionately affects vulnerable populations. Without treatment, VL progresses, causing increasingly severe symptoms and ultimately death within two years, in most cases. Early access to VL diagnosis and care improves clinical prognosis and reduces transmission from infected humans; however, significant obstacles exist. To our knowledge, our study is the first in Ethiopia to use qualitative methods to assess barriers to VL diagnosis and care among seasonal mobile workers. Strikingly, we found that contrary to what health policy for VL dictates in this endemic setting, study participants reported very poor access to diagnosis and, consequently, significantly delayed access to treatment. Our findings have important public health and policy implications. Specifically, our results offer strategies that may increase access to VL diagnosis and care, allowing for earlier treatment and better prognoses for VL patients, and reducing the potential health disparities and the overall burden of VL."
Presentations & Materials from KalaCORE Regional Technical Review Meeting: VL control programme overview
From November 29 – December 1 2017, KalaCORE hosted a Regional Technical Review Meeting and Workshop in Addis Ababa, Ethiopia, with representatives from the National Ministry of Health from all 3 KalaCORE-supported country programmes in Africa, DFID Ethiopia and DFID UK, KalaCORE implementing partners, WHO Geneva, WHO Sudan, WHO South Sudan and WHO Ethiopia, the KalaCORE Expert Steering Group, the NTD task force and the NGDO NTD task force.
The meeting succeeded in documenting lessons learned and improvement actions for current strategies across KalaCORE country contexts, prioritising activities for the remainder of the programme, sharing operational research findings for policy implementation, and initiating the pathway for developing the KalaCORE exit strategy and integration of key activities for sustainability.
Oral presentation delivered at the 6th World Congress for Leishmaniasis 16-20 May 2017, Toledo, Spain. Title: Cross-sectional surveys in Bangladesh, Nepal, Ethiopia and Sudan: Understanding treatment seeking and household economic burden for VL patients.
Impact of the current conflict on VL incidence and service delivery capacity in South Sudan (IMA)(WL6 Oral presentation slides)
Oral presentation delivered by Dr. Mounir Lado (IMA, KalaCORE implementing partner) at the 6th World Congress for Leishmaniasis 16-20 May 2017, Toledo, Spain. Title: Impact of the current conflict on VL incidence and service delivery capacity in South Sudan.