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Health Workers' Perspectives on School-Based Mass Drug Administration Control Programs for Soil-Transmitted Helminths and Schistosomiasis in Ogun State, Nigeria.

Akinsolu, F. T.; Abodunrin, O. R.; Olagunju, M. T.; Adewole, I. E.; Ola, O. M.; Abel, C.; Sanni-Adeniyi, R.; Rahman, N. O.; Akanni, O. O.; Njuguna, D. W.; Soneye, I. Y.; Salako, A. O.; Ezechi, O. C.; Varga, O. E.; Akinwale, O. P.

2023-09-19 public and global health
10.1101/2023.09.18.23295753 medRxiv
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BackgroundSoil-transmitted helminths (STH) and schistosomiasis are widespread neglected tropical diseases (NTDs), impacting 1.5 billion individuals, primarily in resource-limited settings. With the highest schistosomiasis prevalence in sub-Saharan Africa, Nigeria treats 20 million annually. Mass Drug Administration (MDA) programs target vulnerable groups like school-age children to tackle these diseases. This study explores health worker perspectives on MDA implementation in Oguns selected LGAs, pinpointing challenges and enablers. Health workers insights enhance program effectiveness, aligning with NTD 2030 goals. Methodology/Principal FindingsThe study used a qualitative research approach involving focus group discussions and in-depth interviews with health workers engaged in neglected tropical disease control programs in Ogun State, Nigeria. A semi-structured questionnaire guided the exploration of ideas, and the data were analyzed using the QRS Nvivo 12 software package. The study found that the school-based MDA control programs efficacy largely relies on strong collaborations and partnerships, particularly with educators, community heads, and other stakeholders. These alliances and strategic communication methods, like town announcements and media campaigns, have been pivotal in reaching communities. However, the program does grapple with hurdles such as parental misconceptions, limited funds, insufficient staffing, and misalignment with the Ministry of Education. It is recommended to boost funding, foster early stakeholder involvement, enhance mobilization techniques, and consider introducing a monitoring card system similar to immunization. Conclusions/SignificanceThe MDA Integrated Control Programs for STH and SCH in Ogun State schools demonstrate a holistic approach, integrating knowledge, collaboration, communication, and feedback. Health workers have shown commitment and adeptness in their roles. However, achieving maximum efficacy requires addressing critical barriers, such as parental misconceptions and funding challenges. Adopting the recommended strategies, including proactive communication, increased remuneration, and introducing a tracking system, can significantly enhance the programs reach and impact. The involvement of all stakeholders, from health workers to community leaders and parents, is essential for the programs sustainability and success. Author SummaryThis study explored what health workers think about the programs in place to help control and prevent certain tropical diseases that are pretty common and affect many people, mainly in areas with limited resources. In Ogun State, Nigeria, these programs often involve giving out medicine to groups who are at high risk, including school children. The health workers shared that working with teachers community leaders, and using various ways to communicate with people have helped reach out to communities. However, they also noted some challenges, such as wrong beliefs held by parents, insufficient funds, and insufficient people to work on the program. To make the program better, the health workers suggest having more money allocated to the program, involving community people early on in the planning, and possibly starting a card system to keep track of the medication given, just like what is done with immunizations. The study underlines the importance of everyone working together -- from health workers to parents and community leaders -- to ensure the program can continue successfully and help more people.

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