Trujillo-Trujillo Julián, Zamora Sara Milena, Bernal Lizarazu María Consuelo, Torres Pérez Myriam Leonor, Bellido Cuéllar Olga Esther, Araque Carol Viviana, Pulido Martínez Sonia Jaqueline, Vargas Peláez Claudia Marcela, Rossi Francisco, Moyano Ariza Luisa Fernanda, Bernal Parra Luz Mery
Ministry of Health and Social Protection, Subdirection of Communicable Diseases, Bogotá, Colombia.
Universidad Nacional Abierta y a Distancia-UNAD, Escuela de Ciencias de la Salud (ECISA), Bogotá, Colombia.
PLoS One. 2024 Dec 11;19(12):e0310143. doi: 10.1371/journal.pone.0310143. eCollection 2024.
One of the most important pillars of action to achieve the elimination of trachoma and soil-transmitted helminth infections as a public health problem is the mass administration, at regular intervals, of azithromycin and anthielmintics, respectively, to a high proportion of the eligible population in endemic areas.
The objective of the study was to identify access barriers and facilitators for achieving coverage goals in the mass drugs administration, azithromycin and albendazole, in the department of Amazonas, Colombia.
Implementation research was used, combining three types of qualitative research methodologies to collect information about access barriers and facilitators already described; These were individual and group interviews, focus group discussions and face-to-face intercultural dialogues. We design, validate and apply different instruments with questions adapted to the context and role of the participants, and recorded and transcribed the sessions and analyzed them in qualitative analysis software. We used the Consolidated Framework for Implementation Research (CFIR) to complement the above instrument questions, to guide data analysis, and apply the Consolidated Criteria for Reporting Qualitative Research (COREQ).
Records of 159 participants were included; 21 individual and 3 group interviews, 6 focus group discussions and 4 intercultural dialogues were carried out. 21 strong, 30 weak, 6 neutral barriers as well as 5 weak and 11 strong facilitators were identified. 62% of the strong barriers and 40% of the weak ones were concentrated in the "Outer Setting Domain". Only 16 facilitators were identified, 44% in the "Innovation" domain.
Multiple political, administrative, geographical, logistical and cultural access barriers, as well as external and internal migration of the population, explain low coverage in mass administration of azithromycin and albendazole. It is necessary to review them individually to implement an improvement plan that also recognizes the identified facilitators.
实现消除沙眼和土壤传播的蠕虫感染这一公共卫生问题的最重要行动支柱之一，是定期分别向流行地区高比例的 eligible 人群大规模施用阿奇霉素和驱虫药。
本研究的目的是确定在哥伦比亚亚马孙省实现大规模药物施用（阿奇霉素和阿苯达唑）覆盖目标的获取障碍和促进因素。
采用实施研究，结合三种定性研究方法来收集有关已描述的获取障碍和促进因素的信息；这些方法包括个人和小组访谈、焦点小组讨论以及面对面的跨文化对话。我们设计、验证并应用了不同的工具，其问题根据参与者的背景和角色进行了调整，并对会议进行了记录、转录，并在定性分析软件中进行了分析。我们使用实施研究综合框架（CFIR）来补充上述工具问题，以指导数据分析，并应用定性研究报告综合标准（COREQ）。
纳入了159名参与者的记录；进行了21次个人访谈和3次小组访谈、6次焦点小组讨论以及4次跨文化对话。确定了21个强障碍、30个弱障碍、6个中性障碍以及5个弱促进因素和11个强促进因素。62%的强障碍和40%的弱障碍集中在“外部环境领域”。仅确定了16个促进因素，其中44%在“创新”领域。
多种政治、行政、地理、后勤和文化获取障碍，以及人口的外部和内部迁移，解释了阿奇霉素和阿苯达唑大规模施用覆盖率低的原因。有必要对它们进行逐一审查，以实施一项也认可已确定的促进因素的改进计划。
