Evaluation of MDA restart in the context of COVID-19 in Kwara and Kano, Nigeria

Research question

1. Can MDA resume and achieve high performance while minimizing risk of COVID-19 transmission through adherence to SOPs?

2. Can local teams easily implement the recommended modifications to MDAs; what is the added cost; and how do the above vary by context?

3. What aspects of local context influence implementation of SOPs?


  • Availability of PPE was a key factor in deciding if/when to restart MDAs. Some CDDs who were forced to cover the cost for their own PPE found this to be particularly demotivating. Reliance on donors to cover added costs was widely reported.

  • SOPs promoting good hygiene and infection mitigation techniques during MDA were described as essential by stakeholders. These had not existed previously, leading to poor levels of hygiene during previous MDA.

  • CDDs expressed appreciation for the longer training provided during these campaigns, not only for fully understanding COVID prevention measures but also for gaining greater knowledge of NTDs.

  • Some community members, particularly youth, refused to take medicines as they feared they were COVID vaccines.

  • With a few exceptions, community members felt that the extra emphasis on MDA and COVID-19 awareness prior to the campaign increased acceptance and understanding of the MDA process. This emphasis on sensitization led to higher levels of coverage. Pictorial teaching and learning tools were particularly important.