Sitoe Mercia, Candrinho Baltazar, Baker Kevin, Machava Jossias, Passe Regina, Tarquino Ivan Alejandro Pulido
Malaria Consortium, Maputo, Mozambique.
National Malaria Control Program (NMCP), Maputo, Mozambique.
BMC Public Health. 2025 May 26;25(1):1934. doi: 10.1186/s12889-025-23092-6.
Seasonal malaria chemoprevention (SMC) is a highly effective intervention to prevent malaria in children, in high transmission areas that have seasonal peaks. Since 2020, SMC with sulfadoxine -pyrimethamine plus amodiaquine (SPAQ) has been implemented in northern Mozambique. During SMC campaigns community leaders are involved in the sensitisation and mobilisation of households prior to the start of the SMC round. This qualitative study explores perceptions among caregivers and other stakeholders of the importance of community leader and community distributor engagement for enhancing community knowledge, acceptance and uptake of SMC.
A qualitative study, consisting of focus group discussions (FGDs) and key informant interviews (KIIs), was conducted in four districts of Nampula province in northern Mozambique during two SMC campaign rounds. Focus group discussions were conducted with caregivers whose children received SMC, and implementers involved in delivering SMC. Key informant interviews were conducted with stakeholders actively involved in SMC implementation at national, provincial, and district levels. Participants were identified through purposive sampling. All FGDs and KIIs were conducted in Portuguese or Emakhuwa. Data were coded and thematically analysed using MAXQDA2022.
Between April 2021 and June 2022, KIIs were conducted with community leaders (n = 11) and stakeholders at national (n = 8), province (n = 8) and district level (n = 4). Focus group discussions (FGDs) (n = 42) were conducted with caregivers (n = 152), community distributors (n = 70), community distributors' supervisors (n = 23) and health workers (n = 30). Findings showed there was unanimous recognition among caregivers, community distributors, and key stakeholders, of the critical role community engagement played during the SMC campaign. Caregivers reported obtaining information about SMC from local leaders, and that community distributors provided additional information and helped to build trust, and reduced anxiety and distrust towards the medication. Community leaders' participation during community distributors household visits was also reported to promote participant recruitment, fostering a sense of intervention ownership. Stakeholders believed that the active involvement of community leaders helped prevent misinformation about the SMC campaign.
Involving community leaders in the mobilisation and distribution of interventions, such as SMC, helps to facilitate active participation from the community and result in greater acceptability and community uptake.
季节性疟疾化学预防（SMC）是一种在疟疾传播季节性高峰期的高传播地区预防儿童疟疾的高效干预措施。自2020年以来，莫桑比克北部已实施了磺胺多辛-乙胺嘧啶加阿莫地喹（SPAQ）的季节性疟疾化学预防措施。在季节性疟疾化学预防活动期间，社区领袖在活动开始前参与对家庭的宣传和动员工作。本定性研究探讨了照顾者及其他利益相关者对社区领袖和社区分发人员参与活动以增强社区对季节性疟疾化学预防的了解、接受度和采用率的重要性的看法。
在莫桑比克北部楠普拉省的四个地区，于两轮季节性疟疾化学预防活动期间开展了一项定性研究，该研究包括焦点小组讨论（FGD）和关键 informant 访谈（KII）。与孩子接受了季节性疟疾化学预防的照顾者以及参与提供季节性疟疾化学预防服务的实施人员进行了焦点小组讨论。与在国家、省和地区层面积极参与季节性疟疾化学预防实施工作的利益相关者进行了关键 informant 访谈。通过目的抽样确定参与者。所有焦点小组讨论和关键 informant 访谈均使用葡萄牙语或埃马库瓦语进行。使用 MAXQDA2022 对数据进行编码和主题分析。
在2021年4月至2022年6月期间，与社区领袖（n = 11）以及国家（n = 8）、省（n = 8）和地区层面（n = 4）的利益相关者进行了关键 informant 访谈。与照顾者（n = 152）、社区分发人员（n = 70）、社区分发人员的主管（n = 23）和卫生工作者（n = 30）进行了焦点小组讨论（n = 42）。结果显示，照顾者、社区分发人员和关键利益相关者一致认识到社区参与在季节性疟疾化学预防活动中发挥的关键作用。照顾者报告称从当地领袖那里获得了有关季节性疟疾化学预防的信息，并且社区分发人员提供了更多信息，有助于建立信任，减少对该药物的焦虑和不信任。据报告，社区领袖在社区分发人员家访期间的参与也促进了参与者招募，培养了对干预措施的主人翁意识。利益相关者认为，社区领袖的积极参与有助于防止关于季节性疟疾化学预防活动的错误信息传播。
让社区领袖参与季节性疟疾化学预防等干预措施的动员和分发，有助于促进社区的积极参与，并提高接受度和社区采用率。
