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Madison County Health Department Harm Reduction Monitoring and Evaluation Grant Spotlight

Mar 30, 2023

With support from the Centers for Disease Control and Prevention (CDC) and in partnership with the University of Washington (UW), The National Association of County and City Health Officials (NACCHO) provided funding and technical assistance to nine local health department (LHD) and community-based syringe services programs (SSPs) to support and strengthen monitoring and evaluation (M&E) efforts and systems with a funding opportunity entitled “Building Capacity for Harm Reduction Monitoring and Evaluation.

Throughout the upcoming weeks, we’d like to highlight several of these sites and share successes and lessons learned from their M&E projects.

One recipient, Madison County Health Department in Richmond, Kentucky, explained how they utilized the grant money.

After realizing that the number of participants coming in often was very low, they “conducted in-depth interviews with 153 current or potential SSP participants and discovered: 1) state law had changed, allowing individuals to purchase syringes at a pharmacy without a prescription or identification; and 2) [their] locations are very difficult for people without consistent transportation to access,” said Madison County Health Department representatives.

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They noted that many participants were purchasing syringes from pharmacies because they strongly disliked the retractable syringes that the health department was offering. They also noted that there were several transportation barriers to accessing these SSPs. To address these issues, they “presented this information to community stakeholders, gained support, and are in the process of switching to non-retractable syringes (where allowed by local government) and exploring mobile exchange.”

When asked how their team improved existing harm reduction monitoring and evaluation infrastructure, they responded, “our team became much more confident in the process of initiating, collecting, analyzing, and using qualitative data as part of our troubleshooting toolbox. This project allowed us to both learn new skills that will help us continue to improve and begin making changes that will better meet the needs of our participants.”

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This grant highlighted several obstacles and barriers for those in need of SSP services. Although there was a lot of trial and error, Madison County Health Department gained invaluable insight that is being used to improve harm reduction services in the future.

“It is easy to make assumptions about the causes of a problem,” they said. “Instead of assuming, dig deeper, ask good questions, listen carefully, and take bold action to meet the actual needs of the people you support.”

They also noted that “the process of collecting and using qualitative data is not limited to researchers.” Lastly, they advised, “don’t be intimidated by what you don’t know. Engaging in the process taught us how to do the process better as we moved along.”

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Madison County Health Department utilized this grant in the most productive way possible to strengthen existing harm reduction services. The advice they give and lessons they learned can be used to advise other SSPs that are looking to improve these services as well.

Contact Kat Kelley ([email protected]) with any questions about this project. If your organization is interested in free technical assistance to support harm reduction M&E, visit the National Harm Reduction Technical Assistance Center, which offers free help to anyone in the country providing (or planning to provide) harm reduction services to their community.


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