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Table 9 Item-level median and interquartile ranges in India (n = 74)

From: Structural readiness to implement community-wide mass drug administration programs for soil-transmitted helminth elimination: results from a three-country hybrid study

Construct

Sub-construct

Item

Policymakers

N=3

Mid-level managers

N=5

Implementers

N=66

Change commitment

Needed

I believe that India needs to interrupt STH transmission.

5.0 (0)

5.0 (0)

5.0 (0)

I have observed that my co-workers generally believe that India needs to interrupt STH transmission.

5.0 (0)

5.0 (1.0)

5.0 (0)

Needed median

5.0 (0)

5.0 (0.5)

5.0 (0)

Motivated

I am supportive of implementing community-wide MDA for STH.

5.0 (0)

5.0 (0)

5.0 (0)

I have observed that my co-workers are generally supportive of implementing community-wide MDA for STH.

5.0 (0)

5.0 (1.0)

5.0 (0)

Ministry of Education personnel that I work with on school or child interventions will likely support transitioning from school-based to community-wide deworming.

4.0 (2.0)

5.0 (0)

5.0 (0)

In my experience, community drug distributors are given sufficient financial and/or non-financial incentives for administering community-wide MDA.

5.0 (3.0)

5.0 (2.0)

4.0 (3.0)

Motivated median

5.0 (0)

5.0 (0)

5.0 (0)

Outcome expectancy

I believe that community-wide MDA can interrupt STH transmission in India.

5.0 (0)

5.0 (0)

5.0 (0)

I have observed that my co-workers generally believe that community-wide MDA can interrupt STH transmission in India.

5.0 (0)

5.0 (1.0)

5.0 (1.0)

Outcome expectancy median

5.0 (0)

5.0 (0.5)

5.0 (0.5)

Change commitment median

5.0 (0)

5.0 (0)

5.0 (0)

Change efficacy

Task demand

In my experience, community drug distributor supervisors provide good guidance to distributors on how to deliver community-wide MDA.

  

5.0 (0.5)

[Stakeholder level] staff will need additional training to effectively deliver community-wide MDA for STH.

4.0 (1.0)a

3.0 (1.0)

1.0 (1.0)

Additional supervisors are needed at [stakeholder level] to coordinate the delivery of community-wide MDA for STH.

1.0 (3.0)a

2.0 (1.0)

1.0 (3.0)

In my experience, personnel at [stakeholder level] have demonstrated that they can deliver other community-wide MDA programmes (ex. lymphatic filariasis) with high coverage.

5.0 (2.0)

5.0 (0)

5.0 (1.0)

Task demand median

4.0 (1.0)

2.0 (1.0)

3.0 (2.0)

Resource availability

How often have you observed difficulties with having enough funding at the National level to support implementation of community-based programmes?

3.0 (2.0)

4.0 (0)

3.0 (2.0)b

How often do you encounter difficulties with having enough funding at the district level to implement of community-based programmes?

2.0 (3.0)

4.0 (0)

3.0 (2.0)

I am not worried about whether India has sufficient future funding for community-wide MDA programmes.

3.0 (4.0)c

3.0 (2.0)

 

India currently has the resources and tools needed to develop high-quality sensitization and education materials for community-wide MDA for STH.

5.0 (3.0)

4.0 (0)

5.0 (2.0)

In my experience, there is an effective programme in India for training community drug distributors on how to deliver community-wide MDA.

4.0 (2.0)

4.0 (1.0)

4.5 (2.0)

I know of at least one community health programme that could be used to deliver community-wide MDA for STH.

5.0 (1.0)

4.0 (1.0)

5.0 (2.0)

Resource availability median

4.0 (3.0)

4.0 (0)

4.5 (1.5)

Contextual factors

I have observed that there is a collaborative network of external stakeholders (NGOs or technical/financial partners) that would support community-wide MDA for STH in India.

5.0 (0)

5.0 (0)

5.0 (1.0)

How often are community members in India resistant to community-wide MDA campaigns?

4.0 (2.0)

4.0 (2.0)

5.0 (1.0)

Contextual factors median

4.5 (1.0)

4.5 (1.0)

4.5 (1.0)

Change efficacy median

4.0 (2.5)

4.0 (0)

4.5 (1.5)

Organizational readiness for change

5.0 (0.5)

4.0 (1.0)

5.0 (0.5)

Capacity

Demonstrated capacity

In my experience, India‘s National NTD Master Plan is currently being implemented as intended.

3.0 (2.0)

3.0 (2.0)

 

How often have you encountered difficulty moving money across [stakeholder level of the health system] for a community-based programme?

3.5 (1.0)c

4.0 (0)

3.0 (3.0)b

How often have you observed delays in the arrival of drugs for MDA programmes due to supply chain problems?

2.0 (1.0)

5.0 (1.0)

5.0 (2.0)

I have observed that it is challenging to recruit enough community drug distributors needed in India to deliver community-wide MDA.

1.0 (2.0)

2.0 (0)

3.0 (4.0)

How often are treatment data incorrectly recorded during delivery of community-wide MDA programmes?

3.0 (1.0)

4.0 (1.0)

4.5 (2.0)

In my experience, community drug distributors have the skills to effectively deliver community-wide MDA for STH.

3.0 (2.0)

5.0 (0)

5.0 (1.0)b

  

Demonstrated capacity median

3.0 (1.0)

4.5 (1.0)

5.0 (2.0)

Flexibility

Flexibility

It is challenging to present new ideas to my supervisor.

1.0 (0)c

4.0 (1.0)

 

In my experience, when MOH leadership at the National level are presented with new ideas, research activities, or pilot projects, they are generally receptive to them.

5.0 (0)a

4.0 (1.0)

 

How often do your supervisors generally feel comfortable receiving feedback and recommendations from you and your colleagues on how to improve the delivery of interventions?

5.0 (0)c

5.0 (2.0)

 

How often do your subordinates generally feel comfortable providing feedback and recommendations on how to improve the delivery of interventions?

5.0 (0)c

5.0 (0)

 

Flexibility median

5.0 (0)

4.5 (0.5)

 

Organizational structure

Leadership structure

In my experience, the NTD programme leadership at the national level is effectively implementing community-wide MDA programmes in India.

5.0 (0)a

5.0 (2.0)

 

In my experience, the NTD programme leadership at the [STATE] level is effectively implementing NTD programmes in India.

4.0 (1.0)a

5.0 (2.0)

 

In my experience, the NTD programme leadership at the [DISTRICT]l level is effectively implementing NTD programmes in India.

4.0 (1.0)a

5.0 (1.0)

 

Leadership structure median

4.0 (1.0)

5.0 (2.0)

 

Political structure

In my experience, India's national policy for NTD control supports community-wide MDA.

5.0 (2.0)a

  

I have observed that India’s National NTD Master Plan provides sufficient guidance for delivering community-wide MDA programmes, such as lymphatic filariasis (LF).

4.0 (2.0)a

3.0 (2.0)

 

I have observed that deworming medicines are acquired centrally and re-distributed to local levels without too much difficulty.

4.0 (3.0)

5.0 (0)

5.0 (0)b

Political structure median

5.0 (2.0)

4.0 (1.0)

5.0 (0)

Organizational structure median

4.5 (1.5)

5.0 (2.0)

5.0 (0)

Organizational capacity for change

4.5 (1.0)

4.5 (1.0)

5.0 (1.5)

Summary item: I believe that India is ready to implement community-wide MDA for STH for the first time

3.0 (1.0)

5.0 (0)

5.0 (1.0)

  1. aImplementation partners not asked the question
  2. bCDDs not asked the question (only health centers)
  3. cImplementation partners and WHO not asked the question