Gambia

Areas eligible for SMC and areas where SMC is implemented in 2020

Photo: NMCP Gambia

Cycle

Children 3 - 59 months targeted

Children 3 - 59 months reached

Efficiency

Cycle 1

210950

127274

60%

Cycle 2

210950

130795

62%

Cycle 3

210950

122933

58%

Cycle 4

210950

121227

57%

Monitoring of coverage completeness

Photo: child smiling

Administrative coverage

  • Administrative coverage based on the number of courses administered was tallied daily from each distribution team and aggregated by district and then Regional level.
  • Reports from health posts and delivery tools developed to document day to day activities of drug delivery teams were collected and compared with registers to check for consistency

Full SMC coverage

  • Full SMC coverage was based on the as the proportion of children aged 3-59 months who received the required complete 3-day treatment course during the SMC round from the complete clean synced data from the commCare platform

Monitoring of compliance

  • The field data quality team monitors for adherence.

Successes

  • Reorganising the team movement in Kantora district helped to increase coverage compared with previous campaign coverage.
  • Creation of more operational sites to improve access, helped increase coverage in some districts in WR2.
  • Use of T-shirts enhanced the acceptance of SMC medication in the community.
  • Marking of the compounds where children had received SMC was effective in identifying those that had already received SMC. This also saved time in the mop up process
  • The involvement of religious and other influential leaders in the community to sensitize their communities on the distribution, its benefits, dates and the importance of waiting to receive SMC before going out to the farms was really beneficial.
     

Challenges

  • Refusals by caregiver
  • Heavy rains and flooding resulting in damaged and impassable roads and this made it difficult to access some communities
  • Unavailability of some community members due to farming activities
  • Poor internet connectivity at regional level.  This affected the timely syncing of data and availability of coverage reports
  • Misguided use of social media to spread false information about health interventions


Proposed solutions

  • Additional messages on safe delivery of SMC medicine in the context of COVID-19 conducted in radios and community level.
  • The NMCP should mobilize additional funds to strengthen social and behavioural change communication at the community level
  • Regional teams should visit communities with high refusal rates to sensitize influential leaders on the benefits of SMC to increase their acceptance rate
  • Regional health divisions are encouraged to ensure joint daily team movement planning together with the community members
  • All malicious audio messages intercepted on WhatsApp were addressed as a matter of urgency and forwarded to WhatsApp groups with a telephone number for further clarification

Research priorities for 2021

  • SP/AQ therapeutic efficacy studies: Planned to be implemented in 2021
  • Coverage Studies
  • Monitoring of SMC Adherence

Partners

  • The Global Fund (SPAQ therapeutic studies)