Abstract
The Kenyan Ministry of Health and its partners through the Division of Vector-Borne and Neglected Tropical Diseases, is in charge of the Lymphatic Filariasis Mass Drug Administration programme. This is implemented through the national, county, and sub-county neglected tropical diseases coordinators. The current study sought to understand the roles, challenges faced and suggestions of how program performance can be improved by the community health extension workers, county and sub-county neglected tropical diseases coordinators. Two wards of the Kaloleni sub-county; Kilifi County were purposively selected. In 2015, Kaloleni and Kayafungo wards had a treatment coverage of 58% and 54% respectively; 62% and 39% respectively in 2016, all below the recommended minimum treatment coverage of 65%. Qualitative data was collected through sixteen in-depth interviews with community health extension workers and two semi-structured interviews with the county and sub-county neglected tropical diseases coordinators. Data were analysed by QSR NVIVO version 10 according to identified themes. The study results show the various roles in planning and implementation of the program include; supply chain management; health information education communication and records management; health workforce training and management, leadership and governance, and service delivery. Challenges faced included insufficiency of drugs supplied and information education communication materials, the inadequacy of community drug distributors selected and trained, poor facilitation for training and supervision of community drug distributors, limited duration of the mass drug administration, and delayed reporting due to poor network coverage. The results of this study show that the community health extension workers, county and sub-county neglected tropical diseases coordinators are not fully involved in program leadership and governance, a role that is taken up at the national level. They should be involved in all the stages of the mass drug administration program to create ownership to improve the program performance
Highlights
Lymphatic filariasis (LF) is a neglected tropical disease and that continues to be a major cause of morbidity and permanent disability in endemic populations [1, 2]
Campaign design, the specific activities, and practices they employed in their work and their perceived outcomes, challenges they faced in the implementation of the lymphatic filariasis (LF) mass drug administration (MDA) campaign, insights about how they were received by members of the community during the drug distribution process and their suggestions towards improving the implementation of the LF MDA
A total of two SSIs (n=2) were carried out. These interviews covered issues such as their role, challenges encountered, and views on how the LF MDA campaign can be improved for better performance
Summary
Lymphatic filariasis (LF) is a neglected tropical disease and that continues to be a major cause of morbidity and permanent disability in endemic populations [1, 2]. In the year 2020, WHO launched a roadmap for neglected tropical diseases 2021-2030 aimed at ending the neglect to attain sustainable development goals. This was as a result of not meeting all the targets that had been set for 2020 in the earlier roadmap [4]. The GPELF strategy has been to promote large scale single-dose community-wide mass drug administration (MDA) of antifilarial tablets to entire at-risk populations aged two years and above [5]. This is to ensure the reduction of microfilariae levels in human populations in order to interrupt the transmission cycle between mosquitoes and humans. This is usually dependent on the microfilariae baseline prevalence in the population at risk and other factors determining transmission [7]
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