Abstract
BackgroundThe 2012 London declaration which committed to “sustaining, expanding and extending drug access programmes to ensure the necessary supply of drugs and other interventions to help control soil-transmitted helminths (STH) by 2020” has seen many countries in Africa roll out mass drug administration (MDA) especially among school age children. In Kenya, however, during the National school-based deworming exercise, pre-school aged children (PSAC) have to access treatment at primary schools as the pre-school teachers are not trained to carry out deworming. With studies being conducted on the effectiveness of MDAs, the experiences of key education stakeholders which could improve the programme by giving best practices, and challenges experienced have not been documented.MethodsThis was a cross-sectional qualitative study using Focus group discussions (FGDs) and Key informant interviews (KIIs). It was conducted in 4 sub-counties with high STH prevalence at the Kenyan coast (Matuga, Malindi, Lunga Lunga and Msambweni) to understand best practices for implementing MDA among PSAC.FGDs categorized by gender were conducted among local community members, whereas KIIs involved pre-school teachers, primary school teachers, community health extension workers (CHEWs) and opinion leaders. Participants were purposefully selected with the saturation model determining the number of interviews and focus groups. Voice data collected was transcribed verbatim then coded and analyzed using ATLAS.Ti version 6.ResultsMajority of the primary school teachers and CHEWs reported that they were satisfied with the method of mobilization used and the training tools. This was however not echoed by the pre-school teachers, parents and chiefs who complained of being left out of the process. Best practices mentioned included timely drug delivery, support from pre-school teachers, and management of side effects. Overcrowding during the drug administration day, complexity of the forms (for instance the ‘S form’) and long distance between schools were mentioned as challenges.ConclusionThere is need to utilize better sensitization methods to include the local administration as well as the parents for better uptake of the drugs. Extending deworming training to pre-school teachers will enhance the national deworming programme.
Highlights
The 2012 London declaration which committed to “sustaining, expanding and extending drug access programmes to ensure the necessary supply of drugs and other interventions to help control soil-transmitted helminths (STH) by 2020” has seen many countries in Africa roll out mass drug administration (MDA) especially among school age children
Socio-demographic characteristics of the study population A total of 203 and 154 individuals participated in 20 Focus group discussions (FGDs) and Key informant interviews (KIIs) respectively, in the 4 sub-counties
This study reveals that the use of community health extension workers (CHEWs) is accepted by the community since they are health professionals, it was clear that CHEWs relied heavily on the preschool teachers to identify children who did not qualify for treatment and convince them to take the drugs because the children see the teacher as a familiar face and are more likely to trust them as opposed to a stranger
Summary
The 2012 London declaration which committed to “sustaining, expanding and extending drug access programmes to ensure the necessary supply of drugs and other interventions to help control soil-transmitted helminths (STH) by 2020” has seen many countries in Africa roll out mass drug administration (MDA) especially among school age children. The current World Health Organization (WHO) recommended strategy for control of soil-transmitted helminths (STH) at the community level involves targeted distribution of albendazole (ALB) or mebendazole (MLB) based on the prevalence of infection in school-aged children (SAC) [1,2,3]. The strategy recommends treatment of preschool aged children (PSAC), women of childbearing age and adults at high risk in certain occupations (e.g. teapickers and miners) [4] Based on these recommendations, several STH-endemic countries have rolled out MDA programs that have targeted mainly SAC, leaving out PSAC and adults at high risk. In its strategic plan on “Eliminating soil-transmitted helminths as a public health problem in children”, the WHO aims to increase global PSAC deworming coverage to 75% by 2020 [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
