Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar 24;15(Suppl 1):i30-i42.
doi: 10.1093/inthealth/ihac056.

A quality improvement approach in co-developing a primary healthcare package for raising awareness and managing female genital schistosomiasis in Nigeria and Liberia

Akinola S Oluwole  1 , Anthony K Bettee  2 , Motto Malea Nganda  3 , Helen L Piotrowski  3 , Victoria O Fapohunda  1 , Josephine B Adejobi  1 , Islamiat Y Soneye  4 , Maryam A Kafil-Emiola  4 , Festus O Soyinka  5 , Obiageli J Nebe  6 , Uwem F Ekpo  7 , Karsor K Kollie  8 , Sunday Isiyaku  9 , Rachael Thomson  3 , Laura Dean  3 , Kim Ozano  3 ; Quality Improvement Team
Affiliations

A quality improvement approach in co-developing a primary healthcare package for raising awareness and managing female genital schistosomiasis in Nigeria and Liberia

Akinola S Oluwole et al. Int Health. .

Abstract

Background: Girls and women living in endemic areas for urogenital schistosomiasis may have lifelong vulnerability to female genital schistosomiasis (FGS). For >2 decades, the importance of FGS has been increasing in sub-Saharan Africa, but without established policies for case detection and treatment. This research aimed to understand the level of FGS knowledge of frontline health workers and health professionals working in endemic areas and to identify health system needs for the effective management of FGS cases and prevention of further complications due to ongoing infections.

Methods: Workshops were conducted with health workers and stakeholders using participatory methods. These workshops were part of a quality improvement approach to develop the intervention.

Results: Health workers' and system stakeholders' knowledge regarding FGS was low. Participants identified key steps to be taken to improve the diagnosis and treatment of FGS in schistosomiasis-endemic settings, which focused mainly on awareness creation, supply of praziquantel, development of FGS syndromic management and mass administration of praziquantel to all eligible ages. The FGS intervention component varies across countries and depends on the health system structure, existing facilities, services provided and the cadre of personnel available.

Conclusion: Our study found that co-developing a new service for FGS that responds to contextual variations is feasible, promotes ownership and embeds learning across health sectors, including healthcare providers, NTD policymakers and implementers, health professionals and community health workers.

Keywords: female genital schistosomiasis; health systems; health worker training; participatory research; primary healthcare; quality improvement.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Study pathway (adapted from Wagner et al.).
Figure 2.
Figure 2.
Map highlighting study county location. Source: Liberia Schistosomiasis mapping 2012–2015.
Figure 3.
Figure 3.
Map of Ogun State with the study area expanded to show the waterbody. Source: Produced by AO using ArcGIS 10 software.
Figure 4.
Figure 4.
Nine key steps to developing a contextualised FGS care pathway at the PHC level
See this image and copyright information in PMC

References

    1. No more neglect . Female genital schistosomiasis and HIV: integrating reproductive health interventions to improve women's lives. Geneva: World Health Organization and Joint United Nations Programme on HIV/AIDS, 2019. https://www.unaids.org/en/resources/documents/2019/female_genital_schist... [accessed 2 August 2022].
    1. Ekpo U, Odeyemi O, Sam-Wobo S, et al.Female genital schistosomiasis (FGS) in Ogun State, Nigeria: a pilot survey on genital symptoms and clinical findings. Parasitol. Open 2017; 3:1–9.
    1. Kukula VA, MacPherson EE, Tsey IH, et al.A major hurdle in the elimination of urogenital schistosomiasis revealed: Identifying key gaps in knowledge and understanding of female genital schistosomiasis within communities and local health workers. PLoS Negl Trop Dis 2019; 13(3):e0007207. - PMC - PubMed
    1. World Health Organization . Deworming adolescent girls and women of reproductive age: Policy brief WHO 2021. https://www.who.int/publications/i/item/9789240037670 [accessed 18 June 2022].
    1. World Health Organization . WHO guideline on control and elimination of human schistosomiasis, WHO; 2022https://apps.who.int/iris/bitstream/handle/10665/351856/9789240041608-en... [accessed 2 August 2022]. - PubMed

Publication types