| dc.description.abstract | The World Health Organisation recommends implementation of mass drug administration
(MDA) programmes in areas at high risk of infection with lymphatic filariasis (LF), as a
principle strategy for elimination of the disease. However, these programmes are faced with
numerous challenges some of which include: establishing accurate monitoring and evaluation
systems by the communities, increasing involvement of the local communities and engaging in
effective advocacy for continued MDA for LF support. This study sought to explore how the
various engagement approaches used in MDA for LF shaped community participation in the
programme in Luangwa district of Lusaka province.
A qualitative grounded theory approach was employed in answering the research question at
hand. Aided by the theoretical sampling approach, FGDs (n=9), in-depth (n-5) and key (n=7)
informant interviews were conducted with various participants that included programme
managers, district programme coordinators, health workers, community leaders, community
members, community drug distributors and other key stakeholders.
The results showed that engagement strategies to promote community support and stakeholder
by-in included the use of community health structures, non-governmental organisations
(NGOs) and the district development committee. Awareness creation strategies comprised of
IEC materials, drama, public-address system, community meetings and the door-to-door
approach. Overall, the engagement and awareness creation strategies were effective as most of
the community members had a good understanding of LF, the essence of MDA for LF and its
benefits. Although, the engagement and awareness creation processes were effective, a number
of barriers to implementation such as the short MDA for LF implementation period, mobile
populations, large and distant catchment areas, shortage of drugs, and refusal to take the drugs
hampered community participation. Some strategies such as providing appropriate and timely
incentives, innovative awareness creation and morbidity management were suggested as ways
enhance both community participation and programme implementation.
A theoretical model explaining how community engagement can be made more effective in
facilitating community participation was developed. Three core categories that should be
priority for all programme planners and implementers were identified, namely; well-motivated
community health structures, appropriate and adequate health education and partnership
approaches to MDA for LF implementation, as essential elements in developing an effective
community engagement strategy.
Key words: Community participation, community engagement, lymphatic filariasis, mass drug
administration and implementation. | en |
