Periodic Reporting for period 1 - PDMC Saves Lives (Post-discharge malaria chemoprevention in children with severe anaemia in Benin, Kenya, Malawi and Uganda: Formative and implementation research for policy decision making and implementation)
Okres sprawozdawczy: 2023-07-01 do 2024-12-31
The PDMC Saves Lives project is a comprehensive initiative in young children in sub-Saharan Africa admitted with severe anaemia who are at high risk of post-discharge readmissions and deaths. The project funded by the Horizon Europe Programme involves collaboration between six institutions in Africa and Europe working in close partnership with ministries of health in four endemic countries.
Context and Motivation: The project aims to support the uptake of a new World Health Organization (WHO) recommendation on post-discharge malaria chemoprevention (PDMC) in children admitted with severe anaemia. PDMC has been shown to reduce hospital readmissions by 53% and post-discharge deaths by 77% under trial conditions. However, there is no specific health systems platform for the delivery of PDMC, and implementation studies are now urgently needed to support the introduction and scale-up of PDMC. Our project aims to reduce hospital readmissions and deaths among vulnerable children by providing life-saving medicines of proven efficacy.
Objectives:
Stakeholder Engagement: To engage with national malaria programme managers in the four endemic study countries and explore their perceptions on the PDMC policy and considerations for implementing PD in different contexts.
Stakeholder Engagement: To engage with national malaria programme managers in the four endemic study countries and explore their perceptions on the PDMC policy and considerations for implementing PDMC in different contexts.
Formative Research: To conduct formative research among a range of stakeholders to assess preferences for the drug and regimen for PDMC and the preferred delivery strategy for the monthly PDMC drugs taken in the home.
Implementation Trials: To conduct two implementation trials in Benin and Kenya, co-designed with national stakeholders, to evaluate alternative delivery strategies and their cost-effectiveness to optimise adherence and implementation.
Communication, Dissemination, and Exploitation Strategy: To translate PDMC research results into practical tools and information to support the institutionalisation of PDMC into clinical practice and decision-making tools and inform WHO guidelines on PDMC implementation.
Training and Capacity Building: To design training programmes for research staff on implementation research methodologies and develop the capacity of MoH staff on PDMC in the study sites.
Expected Impact: The expected impact of the PDMC Saves Lives project is significant at national, regional, and global levels:
National Impact: The project has engaged with national stakeholders in Benin, Kenya, Malawi, and Uganda, contributing to the development of strategic plans and generating real-world evidence to support the implementation and policy adoption of PDMC.
Regional Impact: We will generate evidence to support the regional adoption and implementation of PDMC in malaria-endemic regions in East and West Africa. This evidence is crucial for shaping regional health policies and ensuring effective malaria prevention strategies.
Global Impact: The project aims to inform international guidelines on optimal strategies for the implementation of and adherence to PDMC in malaria-endemic regions worldwide. By providing life-saving medicines, the project seeks to improve health outcomes for children under five in low-income, low-resourced malaria-endemic regions.
Integration of Social Sciences and Humanities: The project integrates social sciences and humanities with implementation and health systems research. Formative research has been used to understand the perspectives of key stakeholders and their considerations incorporated into the design of the two implementation trials. These pragmatic trials will assess acceptability and feasibility among health providers and beneficiaries and, together with cost effectiveness analysis, provides context relevant evidence to directly inform policy implementation. This approach ensures that the project addresses the social and cultural contexts of the target populations, as well as diverse health systems, enhancing the effectiveness and sustainability of the PDMC interventions.
Context and Motivation: The project aims to support the uptake of a new World Health Organization (WHO) recommendation on post-discharge malaria chemoprevention (PDMC) in children admitted with severe anaemia. PDMC has been shown to reduce hospital readmissions by 53% and post-discharge deaths by 77% under trial conditions. However, there is no specific health systems platform for the delivery of PDMC, and implementation studies are now urgently needed to support the introduction and scale-up of PDMC. Our project aims to reduce hospital readmissions and deaths among vulnerable children by providing life-saving medicines of proven efficacy.
Objectives:
Stakeholder Engagement: To engage with national malaria programme managers in the four endemic study countries and explore their perceptions on the PDMC policy and considerations for implementing PD in different contexts.
Stakeholder Engagement: To engage with national malaria programme managers in the four endemic study countries and explore their perceptions on the PDMC policy and considerations for implementing PDMC in different contexts.
Formative Research: To conduct formative research among a range of stakeholders to assess preferences for the drug and regimen for PDMC and the preferred delivery strategy for the monthly PDMC drugs taken in the home.
Implementation Trials: To conduct two implementation trials in Benin and Kenya, co-designed with national stakeholders, to evaluate alternative delivery strategies and their cost-effectiveness to optimise adherence and implementation.
Communication, Dissemination, and Exploitation Strategy: To translate PDMC research results into practical tools and information to support the institutionalisation of PDMC into clinical practice and decision-making tools and inform WHO guidelines on PDMC implementation.
Training and Capacity Building: To design training programmes for research staff on implementation research methodologies and develop the capacity of MoH staff on PDMC in the study sites.
Expected Impact: The expected impact of the PDMC Saves Lives project is significant at national, regional, and global levels:
National Impact: The project has engaged with national stakeholders in Benin, Kenya, Malawi, and Uganda, contributing to the development of strategic plans and generating real-world evidence to support the implementation and policy adoption of PDMC.
Regional Impact: We will generate evidence to support the regional adoption and implementation of PDMC in malaria-endemic regions in East and West Africa. This evidence is crucial for shaping regional health policies and ensuring effective malaria prevention strategies.
Global Impact: The project aims to inform international guidelines on optimal strategies for the implementation of and adherence to PDMC in malaria-endemic regions worldwide. By providing life-saving medicines, the project seeks to improve health outcomes for children under five in low-income, low-resourced malaria-endemic regions.
Integration of Social Sciences and Humanities: The project integrates social sciences and humanities with implementation and health systems research. Formative research has been used to understand the perspectives of key stakeholders and their considerations incorporated into the design of the two implementation trials. These pragmatic trials will assess acceptability and feasibility among health providers and beneficiaries and, together with cost effectiveness analysis, provides context relevant evidence to directly inform policy implementation. This approach ensures that the project addresses the social and cultural contexts of the target populations, as well as diverse health systems, enhancing the effectiveness and sustainability of the PDMC interventions.
The PDMC Saves Lives project has advanced in meeting its goals. A data safety monitoring board was set up to manage implementation trials in Kenya and Benin. Consortium meetings, including a virtual kick-off and an annual meeting in Benin, have taken place. The project's website was launched in September 2024. Stakeholder engagement continues across multiple countries, involving national malaria control programs, WHO, research partners, and NGOs. Formative research with stakeholders, including caregivers of children with severe anemia, has helped identify strategies for implementation trials. Findings have guided the development of PDMC medication packaging and caregiver information. Trials in Benin and Kenya are co-designed with local stakeholders. Two PhD students from Benin and Malawi have registered at universities in France and Malawi.
During the first 18 months of this project the PDMC Saves Lives consortium has generated significant evidence through conducted formative research to support the policy adoption and implementation of PDMC in the project’s endemic countries. The project has engaged national stakeholders to share the results of the research and partners have supported the development of national strategic plans and guidelines with ministries of health in Benin, Kenya, Malawi, and Uganda. The results of the formative research will also be published and disseminated internationally. The potential impacts include improved health outcomes for children under five, reduced hospital readmissions, and decreased mortality rates.