World Scabies Program – Kiribati

Health Systems Strengthening for scabies awareness and advocacy in Kiribati.

Status: Active

The World Scabies Program (WSP) in Kiribati supports national efforts to reduce the burden of scabies through integrated mass drug administration (MDA), surveillance, and health systems strengthening (HSS). Working in close partnership with the Kiribati Ministry of Health and Medical Services (MHMS), the program supports delivery of high-coverage treatment campaigns alongside system-level strengthening to ensure sustained scabies control.

Background and Key Milestones

  • August 2025: Kiribati completed the first-ever national integrated MDA program addressing both scabies and trachoma, achieving 87% coverage for scabies. Kiribati is the first WSP country to achieve MDA coverage exceeding 80% of the population.
  • November 2025: A national post-MDA scabies prevalence survey was completed to assess impact.

Key findings included:

  • Baseline scabies prevalence: 24.9%
  • Post-MDA prevalence: 2.0%
  • Attributable risk reduction: 23.0%
  • Relative risk reduction: 92.1%
  • Moderate to severe scabies (>10 lesions): reduced from 16.1% to 1.3%
  • Impetigo prevalence: reduced from 7.9% to 1.5%

These findings demonstrate substantial population-level impact following a single round of integrated MDA.

Current Focus: Mass Drug Administration and Health Systems Strengthening

In 2026, WSP are supporting the MHMS to implement a second-round integrated MDA as part of the national scabies control program. The MDA will again be integrated with trachoma activities at national level.

The 2026 MDA is supported through complementary funding, while ReALiSE focuses on Health Systems Strengthening (HSS) activities to ensure sustained scabies control beyond campaign delivery.

The World Health Organization (WHO) recommends two rounds of MDA for scabies control to achieve elimination as a public health problem. MHMS, WSP, and the Fred Hollows Foundation (FHF) have documented lessons from the initial MDA, which will be applied to strengthen implementation, including improvements in:

  • Community awareness
  • Health worker training
  • Reporting and monitoring systems
  • Population coverage and delivery processes

A second post-MDA prevalence survey will be conducted six months after the 2026 MDA using the same methodology as previous surveys. Findings will inform future scabies control strategies, including surveillance and treatment guidelines.

Health Systems Strengthening (HSS) Approach

While MDA rapidly reduces scabies prevalence, ReALiSE-supported HSS activities are designed to sustain these gains by embedding diagnosis, treatment, surveillance, and community awareness within routine MHMS systems using the WHO HSS Building Blocks.

HSS in Kiribati focuses on strengthening all levels of the health system to ensure coordinated, long-term scabies control.

In November 2025, WSP facilitated a consultation with healthcare workers in South Tarawa to identify priorities for HSS for scabies control.

Health Systems Strengthening Activities (Kiribati, 2026 and 2027)

Health Service Delivery

  • Additional consultations with healthcare workers and key partners to further define HSS priorities
  • Community awareness activities through social media, radio, SMS, newspapers, and World Health Day campaigns
  • Inclusive messaging for hard-to-reach populations, including people with disabilities, through local partnerships
  • Training health workers on scabies diagnosis, treatment, complications, and GEDSI-informed practice
  • Review and update of national scabies treatment and clinical guidelines

Access to Essential Medicines

  • Supporting MHMS Pharmacy Department with procurement, quantification, and tracking of scabies medicines
  • Strengthening medicine supply awareness through training and MHMS communications (including memos and guidance on ordering processes)

Health Systems and Surveillance

  • Engagement with surveillance teams to integrate scabies into routine national surveillance systems
  • Strengthening reporting of crusted scabies within the national notifiable disease system
  • Supporting training and guideline updates related to scabies reporting changes

Leadership and Governance

  • Consultation with senior MHMS stakeholders to guide future scabies control strategies
  • Supporting integration of training and community awareness activities across programs
  • Development of reports and resources documenting lessons from integrated MDA and HSS implementation for regional sharing

Together, these activities strengthen core health system functions for scabies control. The approach combines:

  • High-coverage integrated MDA
  • Sustained health systems strengthening
  • Regional learning and adaptation

Implementation draws on regional experience, including technical support and lessons from scabies control activities in Solomon Islands.

This program is led Dr Susanna Lake and World Scabies Program in collaboration with the Kiribati Ministry of Health and Medical Services, with support from regional implementing and research partners.

 

Miiri Tong conducts scabies mass drug administration in South Tarawa Kiribati in her local community, Tearaereke, June 2026.

Supported by the Australian Government through the Partnerships for a Healthy Region Initiative.