In western Kenya, a five-day campaign recorded higher reach for treatment against the study’s two infections than a programme that integrated treatment into routine primary health care. Campaign-based mass drug administration, or MDA, treated 436,059 of 426,207 targeted people, an administrative coverage rate of 102.3%. The PHC-integrated approach treated 299,960 of 387,852, reaching 77% of its target. Across both models, 736,019 people were treated.
The comparison was quasi-experimental and controlled before and after, rather than a randomized trial. In the PHC arm, treatment was integrated into routine services over three months. The campaign arm used a five-day vertical campaign. In practical terms, one model spread delivery through routine care while the other concentrated it into a short campaign.
What the field comparison covered
The field study covered four counties and 24 wards, split between 12 campaign wards and 12 PHC-integrated wards. Eligible groups included preschool children aged 1 to 4 for STH, school-aged children aged 5 to 14 for both infections, and adults aged 15 or older for SCH. The programme targeted 814,059 people and treated 736,019.
The difference was visible in both the treated totals and the way each programme reached its administrative target. The campaign treated 436,059 people against a target of 426,207, producing 102.3% coverage. PHC integration treated 299,960 against a target of 387,852, producing 77% coverage. The campaign therefore recorded a larger treated population and a higher share of its administrative target in this field comparison.
Those figures describe the two delivery periods examined in the participating wards. They do not automatically show how either approach would perform in a different population or under different operating conditions. The timing was part of the comparison: routine delivery ran across three months, while the campaign was completed in five days.
The numbers behind the comparison
Coverage was only one part of the evaluation. The study asked whether integrating STH and SCH treatment into routine primary health care was cost-effective compared with campaign-based MDA in western Kenya. Its economic analysis was planned alongside a quasi-experimental controlled before-and-after study.
To look beyond the people counted during delivery, the analysis used a Markov state-transition model. That is a way of representing movement among defined infection states from one year to the next. The model simulated a 5,000-person cohort and used 1,000 individuals per year as its analytic denominator. In other words, the field programme supplied treatment counts, while the model supplied a structured way to represent movement among infection states.
That distinction matters because the two kinds of evidence answer different questions. The field figures describe recorded coverage in the participating wards. The model describes annual movement among infection states in a simulated cohort. The two outputs should therefore not be treated as interchangeable.
The cost frame was also narrower than a full accounting of the burden. The analysis took a health-care-system perspective and excluded patient, family, societal and intersectoral costs. It therefore focused on resources counted by the health system, not on every cost that households or the wider society might face.
How to read the result
Because the study was quasi-experimental, the gap in recorded coverage is an association between delivery approach and observed programme reach, not proof that one approach alone caused the difference. The figures show how the two models were recorded in these wards and populations; they do not establish that the same gap would appear in every setting.
The clearest finding is therefore about reach under the conditions measured. The five-day campaign recorded 102.3% administrative coverage, while treatment integrated into routine primary health care recorded 77%. The study provides a structured comparison of those delivery patterns, but its field counts and model outputs need to be read in their separate contexts.
Paper data and sources
Original title: Economic evaluation of primary health care integration and targeted mass drug administration in counties in western Kenya
Authors: Muchangi J, Omondi W, Ndirangu M et al.
Journal/Repository: Frontiers in health services
Status: Peer-reviewed
First online: 2026-10-07
DOI: Not available
Original paper · Full text