Abstract
BackgroundGender remains a recognized but relatively unexamined aspect of the potential challenges for treatment programmes for Neglected Tropical Diseases (NTDs). We sought to explore the role of gender in access to treatment in the Uganda National Neglected Tropical Disease Control Programme.Methodology/Principal FindingsQuantitative and qualitative data was collected in eight villages in Buyende and Kamuli districts, Eastern Uganda. Quantitative data on the number of persons treated by age and gender was identified from treatment registers in each village. Qualitative data was collected through semi-structured interviews with sub-county supervisors, participant observation and from focus group discussions with community leaders, community medicine distributors (CMDs), men, women who were pregnant or breastfeeding at the time of mass-treatment, and adolescent males and females. Findings include the following: (i) treatment registers are often incomplete making it difficult to obtain accurate estimates of the number of persons treated; (ii) males face more barriers to accessing treatment than women due to occupational roles which keep them away from households or villages for long periods, and males may be more distrustful of treatment; (iii) CMDs may be unaware of which medicines are safe for pregnant and breastfeeding women, resulting in women missing beneficial treatments.Conclusions/SignificanceFindings highlight the need to improve community-level training in drug distribution which should include gender-specific issues and guidelines for treating pregnant and breastfeeding women. Accurate age and sex disaggregated measures of the number of community members who swallow the medicines are also needed to ensure proper monitoring and evaluation of treatment programmes.
Highlights
Neglected Tropical Diseases (NTDs) are a group of parasitic, viral and bacterial diseases that affect at least a billion people worldwide [1,2]
The drugs that the community medicine distributors (CMDs) reported distributing in Kidera varied: CMDs in one village reported distributing ivermectin, albendazole and Zithromax; CMDs in a second village reported distributing praziquantel, ivermectin, albendazole and Zithromax; in a third one, praziquantel, albendazole and Zithromax; and in a fourth village, only Zithromax
Annual shipments of praziquantel had been delayed in Kampala in 2011, and communities who distributed praziquantel were relying on remaining tablets from previous years mass drug administration (MDA) campaigns
Summary
Neglected Tropical Diseases (NTDs) are a group of parasitic, viral and bacterial diseases that affect at least a billion people worldwide [1,2]. The current strategies to treat NTDs through these national programmes have largely focused on mass drug administration (MDA), either through school-based treatment of children between the ages of 5–14 or through community-based treatment programmes [10,11]. In the latter, community medicine distributors (CMDs) from Village Health Teams (VHTs) are selected by community members, who are trained to distribute the drugs to the endemic community in conjunction with health education [10,11].
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