Table 5 Modifications to ORIC Survey from Cognitive Interviews

“We can manage the politics of implementing the transition from school-based MDA to community-wide MDA for STH”

We can manage the coordination of all stakeholders involved in implementing the transition from school-based MDA to community-wide MDA for STH.

Word use of “politics” perceived to be related to governance instead of internal management as expected. Perception may create undue tension in typically politically sensitive settings as implementation occurs within government structures.

Respondent 1: “The word politics stands out as a risky word especially if administering the survey to government officials. This is setting yourself for politics-centered discussions because there may be things that are not resolved i.e. internal wars. [This item] is setting the respondents up to become engaged in politics.”

Respondent 2: “Politics is a word that should be avoided. Try to focus on the setting or health climate. This can be tricky especially if there are elections happening. Some people will not respond to this because they fear that they will be talking about their bosses.”

We can handle the challenges that might arise in implementing community-wide MDA for STH.

We can manage the challenges that might arise in implementing community-wide MDA for STH.

The wording of “handle challenges” did not resonate contextually with respondents.

Respondent 1: The word ‘handle’ is difficult. Change it to ‘manage’ as it…links to coordination and collaboration. If you say handle, then saying it is sole responsibility [of one person] but if you say manage, can bring in someone else to help overcome [issues].”

We can keep momentum going while implementing community-wide MDA for STH

Remove

The wording of “keep momentum going” did not resonate contextually with respondents and was too confusing and vague.

Respondent 1: Momentum of what? When we say keep momentum going – where is responsibility being set? We can sustain periodic delays to implementation as long as it is required in country.”

Respondent 3: What is momentum? Do you mean while implementing? What are we talking about? Can mean so many things [such as] momentum with integrating other programmes and partners or managing aspects of same programme.”