Community perception of school‐based delivery of anthelmintics in Ghana and Tanzania
The Partnership for Child Development

Abstract

SummaryThis paper presents the results of an evaluation of community perception of two large-scale, government-run, school-based health programmes delivering anthelmintic drugs to primary school children, in Ghana (80 442 children in 577 schools) and Tanzania (110 000 children in 352 schools). Most teachers (96% in Ghana and 98% in Tanzania) were positive about their role in the programme, including administration of anthelmintic drugs, and parents and children fully accepted their taking on this role. The bene®ts of the programme were apparent to teachers, parents and children in terms of improved health and well-being of the children. Over 90% of parents in both Ghana and Tanzania indicated a willingness to pay for the continuation of drug treatment. The evaluation also highlighted areas that are critical to programme effectiveness, such as communication between schools and parents, the issue of collaboration between the health and education sectors, parents' perception of the importance of helminth infection as a serious and chronic health problem (compared with more acute and life threatening illnesses such as malaria), and who should pay for treatment of side-effects.keywords community perception, Ghana, helminth infection, schistosomiasis, school-based health programmes, Tanzania correspondence C. Maier,

Rumours, Riots and the Rejection of Mass Drug Administration for the Treatment of Schistosomiasis in Morogoro, Tanzania

“…These findings echo earlier difficulties with NTD control in Tanzania (Brooker et al, 2001) and recent research in Uganda continues to detail similar findings (Muhumuza et al, 2015). While the riots in Morogoro town may be an extreme example of rejection of treatment for NTDs, research in Uganda and Tanzania concerning MDA for NTDs also identifies local resistance(s) to treatment for a number of almost identical reasons, including ineffective health education and fears of infertility, illness and even death following treatment (Parker et al, 2008;.…”

“…A survey carried out after the first round of treatment in Tanga, northern coastal Tanzania, in the 1990s reported that while responses within the community were generally positive, parents expressed concern about the lack of communication concerning treatment as not all schools organized a meeting prior to treatment to explain the programme. Teachers reportedly said that while they were happy to administer the drugs, it considerably increased their already heavy workload with little financial incentive (Brooker et al, 2001). Furthermore, they stated that they had encountered some difficulties, such as dealing with children when they suffered side-effects and with parents who had not given consent for their children to be treated (ibid.).…”

Understanding Low Uptake of Mass Treatment for Intestinal Schistosomiasis Among School Children: A Qualitative Study in Jinja District, Uganda

“…While it has been argued that it is cost-effective to deliver interventions through schools (Bundy & Guyatt, 1996;Brooker et al, 2001;Magnussen et al, 2001), it is S. Muhumuza et al 516 important to acknowledge some of the likely limitations. The introduction of the Universal Primary Education (UPE) in Uganda in 1997 increased access to primary education for a large population of children, particularly in rural areas (UBOS, 2012).…”

Impact on a national helminth control programme on infection and morbidity in Ugandan schoolchildren

“…As this method uses the existing school infrastructure and provides easy accessibility to children, it is a cost-effective public health strategy, 8 and many pilot programmes have demonstrated its feasibility, affordability and effectiveness. [9][10][11][12][13] It is unclear, however, whether the observed health benefits of such a control method can be replicated under nationwide programmatic conditions. Earlier large-scale helminth control efforts typically evaluated infection indicators, often prevalence, rather than morbidity indicators, 14,15 but rarely continued due to financial problems and decreased effectiveness.…”