SCI Foundation is now Unlimit Health. Learn more about what the change means for our ongoing efforts to eliminate neglected tropical diseases
Preliminary epidemiological evidence indicates that refugees are exposed to schistosomiasis, soil-transmitted helminths, trachoma, and taeniasis; all treatable neglected tropical diseases(NTDs). To control these diseases, ministries of health (MoHs) often carry out the distribution of medicines to people affected. However, refugees are excluded in these programmes.
Niger hosts around 250,000 refugees including children, elderly, and disabled people, mostly from Nigeria and Mali, due to ongoing conflicts within the Sahel and Lake Chad Basin regions. This population is particularly vulnerable to NTDs, and usually come from poor rural areas, with limited public health or water and sanitation services. Forcefully removed from their homes, they often travel through difficult terrain, arriving at overcrowded settlements that lack adequate sanitation and face reduced access to public health services and economic opportunities.
Implementing partner: Ministry of Health
Timescale: July 2020 – June 2021
Funder: Ascend Learning and Innovation Fund
Ensuring that refugees and displaced persons have access to adequate health services is a principle within the United Nations Leave No One Behind Agenda. Although the provision of health services to refugees is the responsibility of the United Nations’ High Commissioner for Refugees (UNHCR), the Ministry of Health (MoH) and local NTD officials in Niger highlighted the need to strengthen coordination across the public health and humanitarian sectors. This came in response to growing concerns that refugee settlements may act as hotspots for NTDs and that growing and untreated displaced populations may re-introduce NTDs in areas with low disease prevalence.
The World Health Organization’s NTD roadmap for 2030 therefore recommends that refugees have access to treatment.
This project trialled the use of a systems-based approach to identify and examine the factors shaping refugees’ access to preventive chemotherapy (PC) treatment in Niger. A systems-based framework helps to comprehensively outline the interactions between actors, processes, and contextual factors shaping the outcome of an intervention. This in turn helps decision-makers to identify optimal intervention areas for positive change.
The project was implemented in three phases:
The project has helped to expose the following issues:
Drawing on the evidence gathered through this study, local NTD and humanitarian agencies are able to outline critical actions that could improve refugees’ access to PC treatment for NTDs in Niger. Unlimit Health is striving to facilitate further discussion across both types of agencies to foster the development of a common programmatic agenda on the subject, as part of its broader commitment to the Sustainable Development Goal’s principle of ‘Leaving No One Behind’.