Mozambique: First verification survey of MDA coverage

The reported coverage of MDA campaigns needs to be verified at least once during the elimination process. Because these surveys had never happened in Mozambique, CNTD supported the national NTD Programme to plan and conduct the first survey to measure the coverage of Praziquantel (PZQ) after the April-2014 campaign. The exercise was intended to develop skills of staff in the Ministry of Health (MISAU), provinces and districts.

The planning of the survey started in December 2014 using LQAS methodology as this allows for “classification” of districts and the measurement of their performance, as to whether they have reached a pre-determined target or not. It also provides a measure of coverage at the provincial, national or subnational levels.  

The first survey included 16 districts in the 4 northern provinces of Niassa, Nampula, Cabo Delgado and Zambezia.   Working with MISAU staff, almost three months were dedicated to the design of the protocol, the definition of the supervision areas, the questionnaire, the logistics plan and the methodology for electronic data collection and analysis.  Dr Donald Whitson, an expert in M & E and LQAS, provided technical advice and conducted the training.  Drs Carmen Camino and Pilar Hernandez supported planning, budgeting and implementation. Staff from the provinces and the central NTD team were trained in Maputo, taking advantage of their attendance at a WHO training course organized by partners.

Despite preparations, the starting of the survey in Nampula was pandemonium, amidst which the provincial focal point (smiling) was organizing arrivals, accommodation, cars, food, paperwork and other challenges.  LSTM trained all 25 provincial and district focal points who completed a very successful field exercise in Nampula Cidade and the first coverage survey in all districts, as planned. The results were very positive and presented and discussed following the survey.

The following were lessons learned from the activity:

  1. Checklists for each team member are a must! – rather than expecting people to remember details of complicated logistic plans and protocols.
  2. Communication – actively involve all members of the NTD team in Maputo and the provinces, making sure they know what to expect. Don’t assume that communication just happens.
  3. Briefing and debriefing – Briefing the teams regularly and reviewing the checklists’ completion at regular times.  Holding debriefing meetings and keeping records of action points.
  4. Make sure the provincial teams receive contingency funds to pay for “imprevistos”!

Since 2014, two more surveys have been conducted. Surveys to measure coverage and performance after campaigns are now included in the yearly plan for Mozambique.