Reflections on a Community Engagement Strategy for Mass Antimalarial Drug Administration in Cambodia.

Thomas J Peto,Pich Kunthea,Chea Nguon,Bipin Adhikari,Sanann Nou,Nicola James,Rupam Tripura,Renly Lim,Chan Davoeung,Christopher Pell,Phaik Yeong Cheah,Chhouen Heng

doi:10.4269/ajtmh.17-0428

Abstract

.Mass drug administration (MDA) to interrupt malaria transmission requires the participation of entire communities. As part of a clinical trial in western Cambodia, four villages received MDA in 2015–2016. Before approaching study communities, a collaboration was established with the local health authorities, village leaders, and village malaria workers. Formative research guided the development of engagement strategies. In each village, a team of volunteers was formed to explain MDA to their neighbors and provide support during implementation. Public mobilization events featuring drama and music were used to introduce MDA. Villages comprised groups with different levels of understanding and interests; therefore, multiple tailored engagement strategies were required. The main challenges were explaining malaria transmission, managing perceptions of drug side effects, and reaching mobile populations. It was important that local leaders took a central role in community engagement. Coverage during each round of MDA averaged 84%, which met the target for the trial.

Highlights

The spread of drug-resistant parasites poses a serious threat to malaria control in Southeast Asia.[1]
A range of community engagement (CE) activities are undertaken alongside mass drug administration (MDA).[7]
In the global health literature, CE has various definitions, for example, promoting ethical conduct of research, or “working collaboratively” with communities “to address issues affecting the well-being of those people.”[8,9] In this article, we focus on CE as a range of activities with the primary aim of promoting MDA coverage

Summary

Leaders and influential people Village volunteers

Involve village malaria workers Outreach activities with forest goers and migrants Outreach to local opinion formers Outreach to monks Outreach to women/mothers Local school activities Post-MDA follow-up Community concert (2015) Community theater and art workshops (2016) Incentives

Monitoring and evaluation

Collect feedback to adapt the CE strategy

Key experiences and lessons for mass antimalarial drug administration