In every country in the world, health care happens at the community level. When fighting disabling, disfiguring diseases called Neglected Tropical Diseases (NTDs), simple, affordable tools help disease-affected countries in the fight. A dose pole or measuring stick is one such tool that is especially important in low-resource settings. Highly effective, the dose pole is powerful in its simplicity.

A community drug distributor measures a girl’s height against a dose pole

A community drug distributor measures a girl’s height against a dose pole in Cross River State, Nigeria to determine the proper dosage of medicine for LF. Photo Credit: RTI International/Ruth McDowall

What are Neglected Tropical Diseases? 

Neglected Tropical Diseases are diseases that cause considerable human suffering but disproportionately impact poor and marginalized populations. If not prevented, NTDs can cause lifelong disability, which can lead to significant economic and social impacts on affected individuals, communities, and countries. However, NTDs are preventable and treatable with safe, effective medicines that can be given by trained volunteers.

USAID has worked alongside more than 30 countries to distribute donated medicines to communities at risk of five of the most common and burdensome NTDs. 

What is a “dose pole”? How is it used? 

One common tool used in community health to fight NTDs is a measuring stick often called a “dose pole”. It is a simple, inexpensive way for health workers and trained volunteers to quickly determine a person’s medicine dosage, which correlates to height. Scales to measure weight are expensive, heavy, and prone to break. A practical alternative, the dose pole is usually over six feet tall and is sometimes color-coded with dots or images of tablets, with each colored section indicating the number of pills needed to treat an individual. Others use markings or list the dosage outright. 

In Togo a woman wearing a mask is measured against a dose pole to determine how much medicine is needed to help prevent and treat for an NTD during an annual campaign.

In Togo, USAID’s Act to End NTDs | West program conducted an MDA with the help of a dose pole. Credit: Act to End NTDs | West

There are different dose pole types too. Some are simple painted sticks. Others are printed and laminated and can be fastened to a wall before measurement. And sometimes trees or walls are measured and then marked with the proper dosages. Because medicines and doses are different for each disease, there are different types of dose poles for various disease treatment campaigns. In fact, a dose pole will often have two sides showing dosage for two different medicines.

A tree is marked with different doses of medicine. People will stand against the tree before being given their height-based dose of medicines to help prevent and treat NTDs.

A tree marked off by different doses helps determine how much of medications children will receive during a mass drug administration for NTDs. Credit: USAID’s ENVISION Project / RTI International

The simplicity of the design and marking of the dose pole help ensure consistency of treatment, often across hundreds of treatment teams serving millions of people (sometimes in just one country!). 

Health workers carry dose poles during treatment periods called mass drug administration (MDA) campaigns. The campaigns occur on a regular schedule (often annually) which is specific to the disease. They distribute treatments to whole communities in areas where NTDs persist to reduce the prevalence of disease annually and ultimately curb disease spread. For the diseases USAID targets, treatment usually involves the distribution of medicines for at least 3-5 years, if not longer. USAID uses an integrated treatment approach, often treating multiple NTDs at one time, improving both impact and efficiency. USAID also supports the training of hundreds of thousands of community health workers each year to safely administer the treatments.

Portable, inexpensive, and effective, the dose pole is a stellar public health tool. See more photos of NTD elimination work in action at:

By: Brian Guzman, Health Communications and Public Affairs Intern, USAID’s Neglected Tropical Diseases Division