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肯尼亚实现消除淋巴丝虫病目标:关于改善大规模药物管理宣传、沟通及社会动员活动的定性研究

Towards elimination of Lymphatic Filariasis in Kenya: improving advocacy, communication and social mobilization activities for mass drug administration, a qualitative study.

作者信息

Kibe Lydiah W, Kimani Bridget W, Okoyo Collins, Omondi Wyckliff P, Sultani Hadley M, Njomo Doris W

机构信息

Kenya Medical Research Institute - Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Nairobi, Kenya.

Ministry of Health, Kenya - Division of Vector-Borne and Neglected Tropical Diseases, Nairobi, Kenya.

出版信息

Trop Dis Travel Med Vaccines. 2022 Jun 6;8(1):16. doi: 10.1186/s40794-022-00172-8.

Abstract

INTRODUCTION

The Kenya Breaking Transmission Strategy for Neglected Tropical Diseases (NTD) from 2019 to 2023 intensifies advocacy, coordination, and partnerships. The purpose of this study was to explore views and experiences of stakeholders and health workers on ways of improving the Advocacy, Communication and Social Mobilization (ACSM) activities of Mass Drug Administration (MDA) for Lymphatic Filariasis (LF) programs through participatory approaches in Kilifi County, Kenya.

METHODS

Two wards were purposely selected in the Kaloleni sub-county, Kilifi County, where there was an average treatment coverage of 56% in 2015, 50.5% in 2016. Qualitative data collection methods were employed, which included participatory meetings with county stakeholders to understand their views, experiences, and suggestions on how ACSM strategies can be improved in MDA for LF. Twelve In-Depth Interviews (IDIs) were conducted (six with opinion leaders and six with Community Health Extension Workers (CHEWs) and two semi-structured interviews (SSIs) were held with county and sub-county coordinators involved in MDA administration. The aim was to better to understand their perceptions of the NTD program about ACSM, challenges to ACSM strategies, and ways to improve the strategies for ACSM in MDA for LF. The Data was organized and classified into codes and themes using QSR NVIVO version 12.

RESULTS

The study observed the low participation of stakeholders in the ACSM activities of MDA for LF and identified potential areas for stakeholders' involvement to strengthen the activities. Challenges hindering effective implementation of ACSM activities include late delivery of Information, Educational and Communication (IEC) and few IEC materials, insufficient funding, inadequate time allocated to reach the assigned households with messages, messaging, and packaging of information for dissemination due to the vastness of the area. The stakeholders recommended innovative strategies and techniques to improve ACSM activities.

DISCUSSION AND CONCLUSION

The results of this study show key challenges to ACSM implementation of MDA for LF. Implementers need to pay attention to these challenges to enhance the effectiveness of MDA per the Kenya NTD Breaking Transmission Strategy. ACSM efforts in MDA for LF control and elimination should be linked with overarching efforts to mainstream partnerships and coordination in control and elimination.

摘要

引言

肯尼亚2019年至2023年被忽视热带病(NTD)消除传播战略加强了宣传、协调及伙伴关系。本研究旨在通过肯尼亚基利菲县的参与式方法,探索利益相关者和卫生工作者对改善大规模药物管理(MDA)针对淋巴丝虫病(LF)项目的宣传、沟通和社会动员(ACSM)活动方式的看法和经验。

方法

在基利菲县卡洛莱尼分区特意挑选了两个病房区,2015年其平均治疗覆盖率为56%,2016年为50.5%。采用了定性数据收集方法,包括与县利益相关者举行参与式会议,以了解他们对如何在MDA针对LF的活动中改进ACSM策略的看法、经验和建议。进行了12次深入访谈(IDIs)(6次访谈意见领袖,6次访谈社区卫生推广工作者(CHEWs)),并与参与MDA管理的县和分区协调员进行了2次半结构化访谈(SSIs)。目的是更好地了解他们对NTD项目中ACSM的看法、ACSM策略面临的挑战以及改进MDA针对LF的ACSM策略的方法。使用QSR NVIVO 12版本对数据进行整理并分类为代码和主题。

结果

该研究发现利益相关者在MDA针对LF的ACSM活动中的参与度较低,并确定了利益相关者可参与以加强这些活动的潜在领域。阻碍ACSM活动有效实施的挑战包括信息、教育和宣传(IEC)材料交付延迟且数量少、资金不足、由于区域广阔而分配用于向指定家庭传达信息、消息传递和信息包装以进行传播的时间不足。利益相关者建议采用创新策略和技术来改进ACSM活动。

讨论与结论

本研究结果显示了MDA针对LF实施ACSM的关键挑战。实施者需要关注这些挑战,以根据肯尼亚NTD消除传播战略提高MDA的有效性。MDA针对LF控制和消除的ACSM努力应与将伙伴关系及协调纳入控制和消除工作主流的总体努力相联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b859/9169390/ea8dfe9df5a7/40794_2022_172_Fig1_HTML.jpg

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