Study design and data collection
DISEASE, TRANSFORMING
A state selection tool was developed and included a multi-criteria decision analysis (MCDA) with six categories: STH epidemiologic profiles, helminth associated morbidity, presence of helminth transmission risk factors, community wide public health coverage indicators, and human resource capacity to engage in intensified STH programming. The purpose of this tool was to select three states from diverse Indian regions (north, south, east/northeast, and west/central), with a high potential for STH transmission interruption. All states and territories were scored and scores were shared during a national-level meeting at National Institution for Transforming India (NITI) Aayog in October 2018 with government stakeholders (Child Health division, Women and Child Health department, National Centre for Disease Control, Indian Council of Medical Research, and members of NITI Aayog) and non-governmental technical support partners (Nutrition International, the Bill & Melinda Gates Foundation, UNICEF, Child Investment Fund Foundation, All India Institute of Medical Sciences, and Christian Medical College, Vellore). During this meeting, three states were selected from three regions: Goa (West/Central), Odisha (East), and Sikkim (Northeast). Goa and Odisha are LF endemic states, with a mix of districts either actively conducting MDA or already in a post-MDA surveillance phase. The study population included the government officials responsible for state-level NTD decision making and implementation in Goa, Sikkim, and Odisha. They were purposefully selected from officers and decision makers directly responsible to training, executing, and monitoring the program. They were invited to participate in three data collection streams: organizational readiness surveys, key informant interviews, and program mapping.