Evidence map›Paper›PMID 38238023›Full record

ArticleBMJ global health2024

Multimethod evaluation of health services integration for neglected tropical diseases requiring case management in Liberia.

Karsor K Kollie, Sally Theobald, Lent Jones, Otis Kpadeh, Gartee Nallo, Darwosu Borbor, Mark Taylor, Laura Dean, Maneesh Phillip, Tiawanlyn G Godwin-Akpan and 6 more

Abstract read
In one paragraph

Article in BMJ global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Karsor K KollieHealth Services, Ministry of Health, Congo Town Back Road, Monrovia, Liberia karsorkollie@gmail.com.ORCID 0000-0003-4741-3374
Sally TheobaldInternational Public Health, Liverpool School of Tropical Medicine, Pembroke Place Liverpool L3 5QA, UK.ORCID 0000-0002-9053-211X
Lent JonesThe University of Liberia, Pacific Institute for Research Evaluation, Monrovia, Liberia.
Otis KpadehThe University of Liberia, Pacific Institute for Research Evaluation, Monrovia, Liberia.
Gartee NalloThe University of Liberia, Pacific Institute for Research Evaluation, Monrovia, Liberia.
Darwosu BorborCuttington University Graduate School Research Student, Monrovia, Liberia.
Mark TaylorTropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place Liverpool L3 5QA, UK.ORCID 0000-0002-8715-4621
Laura DeanInternational Public Health, Liverpool School of Tropical Medicine, Pembroke Place Liverpool L3 5QA, UK.ORCID 0000-0002-4910-9707
Maneesh PhillipEffect Hope, 90 Allstate Parkway Markham ON L3R 6H3, Ontario, Canada.
Tiawanlyn G Godwin-AkpanAmerican Leprosy Missions Liberia, Monrovia, Liberia.
Deborah Fulamuso MensahAmerican Leprosy Missions, 27 Jungle Road Accra, Ghana.
Anna WickendenInternational Public Health, Liverpool School of Tropical Medicine, Pembroke Place Liverpool L3 5QA, UK.
Jewel T KollieA. M. Dogliotti School of Medicine, University of Liberia, Monrovia, Liberia.
Emerson RogersHealth Services, Ministry of Health, Congo Town Back Road, Monrovia, Liberia.
Zeela ZaizayAction Transforming Lives, Congo Town Back Road Monrovia, Liberia.
Martyn StewartEducation, Liverpool School of Tropical Medicine, Pembroke Place Liverpool L3 5QA, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe WHO neglected tropical disease (NTD) roadmap stresses the importance of integrating NTDs requiring case management (CM) within the health system. The NTDs programme of Liberia is among the first to implement an integrated approach and evaluate its impact.

methodsA retrospective study of three of five CM-NTD-endemic counties that implemented the integrated approach was compared with cluster-matched counties with non-integrated CM-NTD. We compared trends in CM-NTD integrated versus non-integrated county clusters. We conducted a pre-post comparison of WHO high-level outcomes using data collected during intervention years compared with baseline in control counties. Changes in health outcomes, effect sizes for different diseases and rate ratios with statistically significant differences were determined. Complementary qualitative research explored CM-NTD stakeholders' perceptions, analysed through the framework approach, which is a transparent, multistage approach for qualitative thematic interdisciplinary data analysis.

resultsThe detection rates for all diseases combined improved significantly in the intervention compared with the control clusters. Besides leprosy, detection rates improved with large effects, over fourfold increase with statistically significant effects for individual diseases (p<0.000; 95% CI 3.5 to 5.4). Access to CM-NTD services increased in integrated counties by 71 facilities, compared with three facilities in non-integrated counties. Qualitative findings highlight training and supervision as inputs underpinning increases in case detection, but challenges with refresher training, medicine supply and incentives negatively impact quality, equity and access.

conclusionsIntegrating CM-NTDs improves case detection, accessibility and availability of CM-NTD services, promoting universal health coverage. Early case detection and the quality of care need further strengthening.

Indexed as

Case ManagementNeglected DiseasesHealth ServicesHumansLiberiaRetrospective StudiesHealth policyHealth services researchHealth systemsHealth systems evaluationPublic Health

Identifiers

PMID38238023
PMCPMC10806886

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.