Reach was assessed at the district, sub-district, CDD and the individual community member levels.

District level: Reach was measured as the proportion of the district management team members who participated in the training before the 2017 drug distribution.

Sub-district level: Proportion of sub-district management team who participated in the training of the CDDs’ training before 2017 MDA.

Individual community member level: This was assessed using the number of people who received the drug (coverage) during the 2017 MDA.

Multiple data sources through the mixed methods research approach were used to measure the effectiveness of the intervention on the level of knowledge about the LF, understanding of the MDA among the study participants, the involvement of community leaders and the MDA coverage.

We assessed the level of adoption as the proportion of sub-districts that implemented each CEQI intervention component. Through interviews with the study participants, we assessed their knowledge level to ascertain understanding and information given by the interviewers (CDDs, health workers) on the program. If the interviewers determined that the program was not implemented correctly, they were asked the impediments during the implementation and how they planned to overcome them.

The level of implementation was assessed (i.e. fidelity to delivering the CEQI intervention) with the study participants. This was done through IDIs to explore the level of information they have been given and determine how well sub-districts adhered to strategies during the implementation. We also assessed the activities carried out during the implementation of the CEQI from the weekly report submitted by the sub-districts heads of health services and from the WhatsApp platform.

The assessment of the district-, sub-district- and CDD-level maintenance of the intervention was used to determine the extent to which the CEQI intervention can become integrated into the LF MDA’s routine activities.

We also determined the extent to which the intervention implementation team could continue and sustain the intervention activities. A review of barriers and possible solutions to enable the successful implementation of the intervention from the perspective of the participants (through the IDIs and from weekly written reports) was carried out.

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