House to house
Community drug distributors (CDDs)/others visit households to register the household members and distribute drugs | Routinely reported data may be sex disaggregated at community level but frequently not cascaded to national level | Who is chosen to distribute the drugs and why? How are they chosen and who is involved? Are they remunerated? Does this influence who is involved? At what time are drugs distributed? If it is in the evening is it acceptable/does it prompt security concerns? If daytime does this affect the involvement of those who have activities outside the home? Who is available within the household and when? Does CDD gender effect ability to access to household members or enter the home? Does this access also influence individual, household and community adherence? Who has the power to decide whether the medicines are taken or not? Who has the power to provide consent for household members under the age of 18 years? Do power relations at the community level also shape this?
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Fixed point approaches: health post clinic/distribution point
Drugs are distributed by CDDs or health workers at a fixed point | Routinely reported data may be sex disaggregated at facility level but frequently not cascaded to national level | How and to whom is information communicated about the distribution—how does this reflect the needs of migrants, inhabitants of informal settlements, women, men, people of other genders? How does it reflect the literacy levels? Who is able to attend the distribution? How do livelihoods, gender, power and autonomy affect this? Does the location of distribution points influence distribution of medicines, what is the on impact community coverage or the coverage of any specific group within the community?
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Child (under 5) health/special events
Particularly common in the African context, drugs are provided within these gatherings | Routinely reported data not disaggregated at national level, with the possible exception of nutrition | How and to whom is information communicated about the distribution—to what extent does this reflect the needs of women, men, people of other genders migrants, inhabitants of informal settlements? Who is able to attend the distribution? How does livelihoods, gender, power and autonomy affect this? Who has the power to provide consent for the treatment of those under 18 years of age?
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School-based programmes
Teachers and/or others distribute drugs in the schools | Routinely reported data may be sex disaggregated at school level but frequently not cascaded to national level | Who attends school? How is this linked to gender and poverty? How is informed consent negotiated? What happens to those who do not attend school on a regular basis? What happens to those who drop-out of school/do not complete their primary education?
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Coverage improvement activities
for example, mop up
Additional ‘pro-equity’ activities undertaken to try to ensure everyone is covered | No sex disaggregated information and limited documentation on types of approaches | What are the ‘coverage improvement’ strategies? Who decides on them? What baseline/census material do they relate to and who might be potentially excluded from these? Where appropriate how can we ensure women who are pregnant (and unable to take certain drugs) do access them at a later more appropriate date?
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