Piloting the Supervisor's Coverage Tool in Ethiopia: an in-process monitoring tool for MDA at the district-level

Research question

This study is piloting the Supervisor's Coverage Tool (formerly the Coverage Supervision Tool, or CST) approach that is meant to provide a platform for district- and sub-district-level supervisors to monitor the success of the last MDA. It is meant to be conducted at the sub-district level two weeks following MDA and provides a pass/fail result regarding whether the target coverage threshold was met. It is designed as a quick and inexpensive in-process monitoring tool for use by sub-national level NTD management teams/supervisors to help improve or maintain the success of future MDA rounds.


Preliminary Findings and Lessons Learned

A recurring request from the national neglected tropical disease (NTD) programme teams is for a quick, inexpensive and simple tool that the programmes can use to assess preventive chemotherapy (PC) coverage. Consequently, the WHO, in collaboration with partners, has developed a Supervisor’s Coverage Tool (SCT) that can be used to improve the coverage of PC delivered through mass drug administration (MDA). The SCT gives supervisors a supportive supervision tool with which to strengthen the performance of the community drug distributors (CDDs) and their first-level supervisors, providing an opportunity to identify and solve problems related to low MDA coverage. 

This tool was first piloted in the Benishangul-Gumuz region in western Ethiopia in close collaboration with RTI and the regional health bureau. The results suggested that the tool was both feasible for district-level staff to implement and resulted in programmatically useful information. 

The methodology behind this tool was presented at the WHO Working Group on Monitoring and Evaluation of Preventive Chemotherapy (WG M&E) in 2015 and 2016. Evidence from four field studies in Ethiopia, Nigeria (two separate occasions) and the Philippines confirms the value and feasibility of using the Supervisor’s Coverage Tool (SCT) by sub-district health supervisors. 

Consequently, the Scientific and Technical Advisory Group for Neglected Tropical Diseases has recommended that the SCT be made available to national programmes for immediate use. Information from SCT should be used to take appropriate data-driven, corrective action at sub-district levels. Additional evidence will be gathered about the tool’s use and applications in other treatment settings such as school-based platforms and urban settings.

Study sites