From district to community: expanded eligibility, not wider geography, drives schistosomiasis programme costs under revised WHO guidance in Ethiopia and Zimbabwe

Expanded eligibility under revised 2022 WHO guidance drove schistosomiasis programme cost increases in Ethiopia and Zimbabwe, with treatment eligibility rising by 72% and 262% respectively.

• Why it matters: WHO now recommends community-wide treatment and fine-scale data, but ministries need to know what most changes programme scope and budgeting when guidance is updated.
• What they did: Using epidemiological and cost data from Ethiopia and Zimbabwe, the study compared survey designs and five implementation scenarios, tracking target population, praziquantel needs, and delivery costs.
• The result: A geostatistical approach cut sample size by up to 90% and survey costs by ≥72% versus a design-based approach, but praziquantel requirements and delivery costs were driven mainly by expanded age eligibility.

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