Evaluating Context-Specific Evidence-Based Quality Improvement Intervention on Lymphatic Filariasis Mass Drug Administration in Northern Ghana using the RE-AIM Framework.

Abstract BackgroundOver a decade of implementing a global strategy to eliminate lymphatic filariasis in Ghana through mass drug administration, the disease is still being transmitted in 22 districts out of an initial 98 endemic districts identified in 2000. A context-specific evidence-based quality improvement intervention was implemented in the Bole District of Northern Ghana after an initial needs assessment. This study aimed to evaluate the process and impact of the intervention on implementation of lymphatic filariasis mass drug administration in Bole District of Northern Ghana. MethodThe study used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework based on a mixed-methods approach to evaluate the context-specific evidence-based quality improvement intervention. Results The findings of the evaluation showed that there was an improvement in social mobilization and sensitization, knowledge about lymphatic filariasis and mass drug administration process, willingness to ingest the medication, and adherence to the directly observe treatment strategy. We observed a 6.3% increase in the district mass drug administration coverage and reduction in self-reported adverse drug reaction. The level of reach, effectiveness and adoption as the district, sub-district and at the individual participants’ level suggest that the context-specific evidence-based quality improvement intervention is feasible to implement in LF hotspot districts based on initial context-specific needs assessment. ConclusionThe study provided the groundwork for future application of the RE-AIM framework to evaluate the implementation of context-specific evidence-based quality improvement intervention to improve mass drug administration towards the elimination of lymphatic filariasis as a public health problem.