Community Health Workers' Experiences and Perspectives on Mass Drug Administration for Schistosomiasis Control in Western Kenya: The SCORE Project

Abstract

Abstract. The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) includes communitywide treatment in areas with 25% prevalence of schistosomiasis along the shores of Lake Victoria using community health workers (CHWs). The CHWs are key drivers in community-owned mass drug administration (MDA) intervention programs. We explored their experiences and perceptions after initial MDA participation. Unstructured open-ended group discussions were conducted after completion of MDA activities. Narratives were obtained from CHWs using a digital audio recorder during the group discussion, transcribed verbatim and translated into English where applicable. Thematic decomposition of data was done using ATLAS.t.i. software. From the perspective of the CHWs, factors influencing MDA compliance included drug side effects, food supply stability, and conspiracy theories about the "real" purpose of treatment. The interest of CHWs to serve as community drug distributors stemmed from both intrinsic and extrinsic factors. Feedback from CHWs can promote more effective MDA in rural Kenyan communities.

The Effect of a Health Communication Campaign on Compliance with Mass Drug Administration for Schistosomiasis Control in Western Kenya—The SCORE Project

“…The health communication campaign was conducted in 75 villages that are located within 10 km of the shore of Lake Victoria in eight districts of western Kenya, including Kisumu East (4 villages), Kisumu West (2 villages), Kisumu Municipality (2 villages), Homa Bay (6 villages), Rachuonyo North (21 villages), Rarieda (22 villages), Nyakach (3 villages), and Bondo (15 villages). 9 These villages had been included in the community treatment arms of the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) study for gaining control of schistosomiasis, the *Address correspondence to W. Evan Secor, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30341-3724. E-mail: was4@cdc.gov design of which has been described elseswhere.…”

“…E-mail: was4@cdc.gov design of which has been described elseswhere. 9,21 As part of the eligibility criteria, study villages had a Schistosoma mansoni infection prevalence 25% in 13-and 14-year-old schoolchildren at baseline. The communities are mainly in rural parts of western Kenya, and the residents are predominantly involved in subsistence farming and fishing activities.…”

“…The project facilitated the work of the CHWs by providing transportation reimbursement at a rate that was agreed on by the DHMT members (approximately $8 US per day), because the Ministry of Health does not have a fixed rate of remuneration but considers CHWs as volunteers in the community strategy structure. 9 Key messages and communication strategies. During the first round of MDA in 2011, only the CHWs, health officials, and provincial administration were trained by the project, with the expectation that they could, in turn, perform the community sensitization.…”

“…These challenges can, in part, be addressed through improved public communication campaigns as a form of community mobilization. [5][6][7][8][9] Health communication campaigns use mass media and an organized set of activities to generate specific outcomes or influence a large number of individuals. They are often the leading source of information about important health issues.…”

“…Increasing the community's level of awareness about the disease and heightening their understanding of the benefits of the drugs and participation in MDA can lead to closure of the knowledgepractice gap, resulting in improved treatment coverage, behavioral change, and better control of schistosomiasis and other NTDs. 7,9,[18][19][20] To evaluate the impact of a health communication campaign for schistosomiasis control in western Kenya, we collected the perceptions of community health workers (CHWs) with regard to its impact on their ability to deliver praziquantel by MDA.…”