Abstract
INTRODUCTION: Nigeria has a significant burden of NTDs with more than 120 million people at risk of the dominant NTDs namely Lymphatic Filariasis, Onchocerciasis, and Schistosomiasis. Control efforts have involved the four levels of governance with programs focused on vector control, preventive chemotherapy, water, sanitation and health education. However, the coordination across these levels and with multiple stakeholders remains unclear especially in states like Taraba that have received significant funding from local non-governmental organisations. METHODS: This study evaluated NTD control effectiveness across national, state, local, and community levels in Nigeria. Eighty-two stakeholders were interviewed across the 4 governance levels. RESULTS: Findings showed distinct roles of the different stakeholders: the National government sets policies, states adapt and strategise, local governments implement programs, and community leaders drive engagement. There is also some multi-sectoral collaboration and coordination among stakeholders. Challenges included inconsistent drug distribution, inadequate Community Drug Distributor (CDD) incentives, and limited cross-sector coordination. DISCUSSION: NTD control progress has been notable, but to meet WHO's 2030 targets, Nigeria needs expanded partnerships, increased private sector involvement, improved drug distribution, enhanced CDD support, and integrated programs with cross-border collaboration. CONCLUSION: Strengthening multi-sectoral partnerships, improving resource allocation, and engaging community leaders are crucial for advancing NTD elimination in Nigeria. A coordinated approach is essential for sustainable disease control and achieving global health objectives.