Barriers and gaps in utilization and coverage of mass drug administration program against soil-transmitted helminth infection in Bangladesh: An implementation research

Nath, Tilak Chandra; Padmawati, Retna Siwi; Murhandarwati, E. Elsa Herdiana

doi:10.1016/j.jiph.2018.10.002

Cited by 22 publications

(56 citation statements)

References 12 publications

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“…The health system should support CDDs to keep their motivation through incentives and supervision. This agrees with the ndings of systematic reviews and studies done in Kenya and Bangladesh [21][22][23][24].…”

Section: Discussionsupporting

confidence: 91%

A Qualitative Study Exploring Barriers, Facilitators and Solutions to Equitable Coverage of Preventive Chemotherapy Towards the Control and Elimination of Neglected Tropical Diseases in South Omo Zone, Nomadic Setting of Southern Ethiopia: Stakeholders’ Perspectives and Experiences

Asfaw

Hailu

2021

Preprint

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BackgroundDespite substantial progress made towards the control and elimination neglected tropical diseases (NTDs) in Ethiopia using preventive chemotherapy (PC) for lymphatic filariasis, onchocerciasis, schistosomiasis, trachoma, and soil-transmitted helminths, its implementation is facing challenges to achieve equitable coverage especially under mobile populations. This study, therefore, aimed at exploring multiple stakeholders’ perspectives and experiences on barriers, facilitators, and potential solutions to equitable coverage of PC in a mobile nomadic setting of Southern Ethiopia.MethodsThis study was conducted in the South Omo zone in August 2019. Qualitative data collection methods involving key informant interviews (KIIs) and focus group discussions (FGDs) were used to collect data from a total of 27 KIIs and 16 FGDs in a nomadic community of Southern Ethiopia using a semi-structured tool. Data were analyzed using a thematic approach, supported by NVivo 11 software.ResultsThis study revealed multiple barriers affecting equitable access and use of PC, and its facilitators and possible solutions were revealed by taking four dimensions (availability, accessibility, acceptability, and effective coverage) into consideration. The emerged barriers were lack of resource and infrastructure; inadequate information, mobilization and community engagement, lack of awareness, inappropriate scheduling of MDA, distribution of drugs at central point, mobile nature of nomadic communities, security challenges, low school attendance, misconception, misbelief, distrust of government, rumor and drugs’ side-effects, lack of community drug distributors’ (CDDs’) motivation, weak leadership and supportive system. On the other hand, the emerged facilitators were the provision of drugs at no-cost, partners' support, the presence of the religious and cultural organization, and decentralization of services. The possible suggested solutions were increasing partnership, improve supervision, engaging parents in mass drug administration (MDA), arrange a visiting schedule out of working hours, involve the village chief in training, intensify awareness creation, home-to-home visit, and plan mop-up activities.ConclusionsThere is a need of addressing barriers that affect efforts in equitable implementation of MDA to ensure no one is left behind from PC in nomadic settings of Southern Ethiopia. Most importantly, information, mobilization and community engagement, mobile nature of the nomadic community, and high level of low school attendance should take special consideration when MDA is planned in these settings.

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Section: Discussionsupporting

confidence: 91%

A Qualitative Study Exploring Barriers, Facilitators and Solutions to Equitable Coverage of Preventive Chemotherapy Towards the Control and Elimination of Neglected Tropical Diseases in South Omo Zone, Nomadic Setting of Southern Ethiopia: Stakeholders’ Perspectives and Experiences

Asfaw

Hailu

2021

Preprint

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“…While the MDA based strategy to control STHs is proven effective in achieving morbidity control, the government is still facing difficulties in achieving target MDA compliance. In our previous study ( Nath et al, 2019 ), we explored and explained the barriers and gaps of ongoing STHs MDA implementation. Some of the important barriers, such as knowledge gaps, rumors about the side effects of MDA drugs, poor motivation among related stakeholders, and inadequate health promotional activities adversely affected the MDA compliance in Bangladesh ( Nath et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

“…In our previous study ( Nath et al, 2019 ), we explored and explained the barriers and gaps of ongoing STHs MDA implementation. Some of the important barriers, such as knowledge gaps, rumors about the side effects of MDA drugs, poor motivation among related stakeholders, and inadequate health promotional activities adversely affected the MDA compliance in Bangladesh ( Nath et al, 2019 ). Misconceptions and knowledge gap concerning the disease, along with prevailing perceptions toward the control program were reported as a key factor for lower compliance by several authors ( Njomo, 2012 ; Devarajan et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Integration of health education intervention to improve the compliance to mass drug administration for soil-transmitted helminths infection in Bangladesh: An implementation research

Nath

Adnan

Sultana

et al. 2020

Parasite Epidemiology and Control

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Introduction In Bangladesh, the prevention and control strategy of soil-transmitted helminthiasis (STHs) is based on the mass drug administration (MDA) program. Despite bi-annual MDA since 2008, the reported compliance is still below the target, and the STH prevalence is high in several areas. This study was done to assess the feasibility and barriers of integrating health education (HE) intervention to achieve the target MDA compliance in the local context of Bangladesh. Materials and methods A mixed-method study, utilizing PRISM (Practical Robust Implementation Sustainability Model) framework, was conducted between July 2017 to March 2018 in Dhaka and Sylhet divisions of Bangladesh. A total of 640 school-aged children selected from four different schools were divided into intervention and control groups. Eight focus group discussions (FGDs) and eight in-depth interviews (IDIs) were also conducted among 56 adults, including parents of school-aged children, school teachers, and health officers. Results Quantitative findings revealed that HE intervention had a significant role ( P < .05) to improve the mean knowledge score in the intervention group (3.35) compared to the control group (0.29). STH preventive behaviours and MDA participating attitudes were also significantly increased in the intervention group ( P < .05) compared to the control group. Some of the major barriers associated with HE integration identified in the qualitative study were budget deficiencies, inadequate training of program implementers, and information gaps. In contrast, the school environment and positive community attitudes were observed as supportive factors for the integration of HE. Conclusion Increased knowledge score and behaviour changes due to HE intervention demonstrated in this study hint that integration of HE with MDA is feasible and can be promising to promote MDA compliance and to reduce STH prevalence in this setting. However, the allocation of adequate budget, as well as coordination and collaboration with local political context, should be addressed for the sustainability of integration.

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“…In some cases, the unacceptability of the MDA programs has been because of people fearing the side effects of the drugs that are used during the MDA programs or/and do not know how to manage or report these side effects (Babu and Kar 2004). For example, in Bangladesh some parents refused their children to be part of a deworming program because of rumours about that the treatment would make their children sick (Nath, Padmawati et al, 2019). The impact of health education is clearly illustrated in the case of Zimbabwe where the high schistosomiasis treatment coverage was attributed to the fact that most parents of the children who received schistosomiasis treatment had knowledge about schistosomiasis (Chimbari 2012).…”

Section: Summary Of Findingsmentioning

confidence: 99%

Unmet Needs to Treat Schistosomiasis in Children Under Five Years Old in uMkhanyakude District of KwaZulu-Natal, South Africa

Ncube¹,

Mutero²,

Chimbari³

2020

GJHS

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Preventive treatment for schistosomiasis control is a priority objective for the Department of Health (DoH) in South Africa. The uMkhanyakude district of KwaZulu-Natal is one of the districts in which schistosomiasis in a major public health concern. We mapped the unmet resource requirements for a schistosomiasis control mass drug administration (MDA) program targeting children aged five years old and below in the uMkhanyakude District. We interviewed 10 decision makers among the uMkhanyakude Health District staff in order to understand the resources that the district has and the resources that the district needs to implement a schistosomiasis control MDA program targeting children aged five years old and below in the uMkhanyakude district. We analyzed and reported on the resources based on the following categories: financing; coverage; program integration; monitoring and evaluation; infrastructure; materials; human resources and training. We identified the resources that the district has and the resources that the district needs to acquire to implement a schistosomiasis MDA program targeting children aged five years old and below. The resources that the district needs to acquire to implement a schistosomiasis control MDA program for children under five include but are not limited to financing, human resources and digital scales. The uMkhanyakude district has insufficient resources to implement a schistosomiasis control MDA program targeting children aged five years old and below. The cost of the resources that need to be acquired for the program could be reduced by integrating the schistosomiasis control MDA program with existing child health intervention programs for children aged five years old and below. Economic evaluations are necessary to determine the child health program to which the schistosomiasis control MDA program could be most cost-effectively integrated to.

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Barriers and gaps in utilization and coverage of mass drug administration program against soil-transmitted helminth infection in Bangladesh: An implementation research

Cited by 22 publications

References 12 publications

A Qualitative Study Exploring Barriers, Facilitators and Solutions to Equitable Coverage of Preventive Chemotherapy Towards the Control and Elimination of Neglected Tropical Diseases in South Omo Zone, Nomadic Setting of Southern Ethiopia: Stakeholders’ Perspectives and Experiences

A Qualitative Study Exploring Barriers, Facilitators and Solutions to Equitable Coverage of Preventive Chemotherapy Towards the Control and Elimination of Neglected Tropical Diseases in South Omo Zone, Nomadic Setting of Southern Ethiopia: Stakeholders’ Perspectives and Experiences

Integration of health education intervention to improve the compliance to mass drug administration for soil-transmitted helminths infection in Bangladesh: An implementation research

Unmet Needs to Treat Schistosomiasis in Children Under Five Years Old in uMkhanyakude District of KwaZulu-Natal, South Africa

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