The NaSS Study: Evaluating the Implementation and Scale-Up of Nigeria National Sodium Reduction Program

Background

Nearly half of Nigerian adults have hypertension, and Nigeria has announced a national sodium reduction program for population-level hypertension prevention and control based on the WHO’s best buy SHAKE package. Using the WHO’s “Best Buy” SHAKE package, the Nigerian Agency for Food and Drug Administration and Control is leading the implementation and scale-up of a national sodium reduction programme.

This project will evaluate the extent to which the programme is implemented using a type III hybrid, mixed methods study design through repeated stakeholder interviews, populations surveys, and retail surveys. The project builds on the team’s existing NHLBI-funded large-scale hypertension control program with team members from University of Abuja, Northwestern University, and The George Institute for Global Health, the latter of which is performing a parallel, GACD-funded assessment in China with similar methods.

Aims

• Primary aim
  Investigate feasibility, appropriateness, potential acceptability and adoption and, using the CFIR framework, the contextual facilitators, barriers, for implementation and scale-up of Nigeria’s national sodium reduction program.

• Secondary aim
  Measure initial implementation, scale-up, and implementation outcomes and costs of Nigeria’s national sodium reduction program, including specific SHAKE components, via RE-AIM and EPIS frameworks.

• Other aim(s)
  Evaluate baseline and temporal changes in dietary sources of sodium, dietary sodium consumption, and sodium in the Nigerian food supply measured by through cross-sectional surveys.

Project plan

Using a type 3 hybrid study design and the EPIS, CFIR, and RE-AIM frameworks, this study will perform a baseline health needs assessment and follow-up assessments using stakeholder interviews, population surveys, and retail surveys. This embedded study will optimize local, regional, and national implementation and will provide generalizable knowledge about implementation strategies to lower dietary sodium intake at scale.

Funding organisations

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