Barriers and gaps in utilization and coverage of mass drug administration program against soil-transmitted helminth infection in Bangladesh: An implementation research
Background: Bangladesh has implemented school-based mass drug administration (MDA) bi-annually since 2008 aimed to control soil-transmitted helminth (STH) infection. Despite several rounds of MDA, the government is still facing challenges to achieve the target coverage and utilization of the interve...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-03-01
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| Series: | Journal of Infection and Public Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034118301539 |
| _version_ | 1819025383224246272 |
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| author | Tilak C. Nath Retna S. Padmawati Elsa H. Murhandarwati |
| author_facet | Tilak C. Nath Retna S. Padmawati Elsa H. Murhandarwati |
| author_sort | Tilak C. Nath |
| collection | DOAJ |
| description | Background: Bangladesh has implemented school-based mass drug administration (MDA) bi-annually since 2008 aimed to control soil-transmitted helminth (STH) infection. Despite several rounds of MDA, the government is still facing challenges to achieve the target coverage and utilization of the intervention. This study was done to explore and explain the barriers and gaps that hinder the utilization and coverage of MDA for STH. Methods: This research was a mixed method study, was conducted in two selected districts of Bangladesh. A total of 160 questionnaire surveys, 12 in-depth interviews, 8 focus group discussion, and 2 key-informant interviews were done among 238 study participants which included school-age children with relevant parents, school teachers, health workers, community leaders and MDA program managers. Descriptive statistical analysis was used to analyze the quantitative data while thematic analysis was applied for the qualitative data. Results: It was revealed that the participants have positive attitudes towards MDA but they pointed out the limitations in reaching all target population especially non-school going children. The level of knowledge regarding STH and MDA were found different among the study population. The evaluated coverage of MDA was also found lower than that reported. Some major barriers associated with MDA coverage found in this study were drug distribution policy, accessibility to schools, poor record keeping, follow-up, and information dissemination. Inadequate information about population dynamics and rumors about side effects of MDA drugs adversely affected the compliance of the intervention. Insufficient training of drug distributors and poor motivation among stakeholders also added to the barriers. Conclusion: There is the need to re-strategize drug distributing methods and create effective policies to include all targeted population. Use of local channels for community sensitization, adding local distribution points, regular monitoring and follow-up and promotion of health education can possibly enhance both treatment coverage and program infrastructure. Keywords: Barriers, Utilization, Coverage, Mass drug administration, Soil-transmitted helminth |
| first_indexed | 2024-12-21T05:09:48Z |
| format | Article |
| id | doaj.art-72ea4d407a7644529221d913045ec88d |
| institution | Directory Open Access Journal |
| issn | 1876-0341 |
| language | English |
| last_indexed | 2024-12-21T05:09:48Z |
| publishDate | 2019-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj.art-72ea4d407a7644529221d913045ec88d2022-12-21T19:15:05ZengElsevierJournal of Infection and Public Health1876-03412019-03-01122205212Barriers and gaps in utilization and coverage of mass drug administration program against soil-transmitted helminth infection in Bangladesh: An implementation researchTilak C. Nath0Retna S. Padmawati1Elsa H. Murhandarwati2Special Program of Implementation Research on Tropical Diseases, Faculty of Medicine, Universitas Gadjah Mada, Indonesia; Department of Parasitology, Sylhet Agricultural University, Bangladesh; Corresponding author at: Special Program of Implementation Research on Tropical Diseases, Faculty of Medicine, Universitas Gadjah Mada, Indonesia.Faculty of Medicine, Universitas Gadjah Mada, IndonesiaFaculty of Medicine, Universitas Gadjah Mada, IndonesiaBackground: Bangladesh has implemented school-based mass drug administration (MDA) bi-annually since 2008 aimed to control soil-transmitted helminth (STH) infection. Despite several rounds of MDA, the government is still facing challenges to achieve the target coverage and utilization of the intervention. This study was done to explore and explain the barriers and gaps that hinder the utilization and coverage of MDA for STH. Methods: This research was a mixed method study, was conducted in two selected districts of Bangladesh. A total of 160 questionnaire surveys, 12 in-depth interviews, 8 focus group discussion, and 2 key-informant interviews were done among 238 study participants which included school-age children with relevant parents, school teachers, health workers, community leaders and MDA program managers. Descriptive statistical analysis was used to analyze the quantitative data while thematic analysis was applied for the qualitative data. Results: It was revealed that the participants have positive attitudes towards MDA but they pointed out the limitations in reaching all target population especially non-school going children. The level of knowledge regarding STH and MDA were found different among the study population. The evaluated coverage of MDA was also found lower than that reported. Some major barriers associated with MDA coverage found in this study were drug distribution policy, accessibility to schools, poor record keeping, follow-up, and information dissemination. Inadequate information about population dynamics and rumors about side effects of MDA drugs adversely affected the compliance of the intervention. Insufficient training of drug distributors and poor motivation among stakeholders also added to the barriers. Conclusion: There is the need to re-strategize drug distributing methods and create effective policies to include all targeted population. Use of local channels for community sensitization, adding local distribution points, regular monitoring and follow-up and promotion of health education can possibly enhance both treatment coverage and program infrastructure. Keywords: Barriers, Utilization, Coverage, Mass drug administration, Soil-transmitted helminthhttp://www.sciencedirect.com/science/article/pii/S1876034118301539 |
| spellingShingle | Tilak C. Nath Retna S. Padmawati Elsa H. Murhandarwati Barriers and gaps in utilization and coverage of mass drug administration program against soil-transmitted helminth infection in Bangladesh: An implementation research Journal of Infection and Public Health |
| title | Barriers and gaps in utilization and coverage of mass drug administration program against soil-transmitted helminth infection in Bangladesh: An implementation research |
| title_full | Barriers and gaps in utilization and coverage of mass drug administration program against soil-transmitted helminth infection in Bangladesh: An implementation research |
| title_fullStr | Barriers and gaps in utilization and coverage of mass drug administration program against soil-transmitted helminth infection in Bangladesh: An implementation research |
| title_full_unstemmed | Barriers and gaps in utilization and coverage of mass drug administration program against soil-transmitted helminth infection in Bangladesh: An implementation research |
| title_short | Barriers and gaps in utilization and coverage of mass drug administration program against soil-transmitted helminth infection in Bangladesh: An implementation research |
| title_sort | barriers and gaps in utilization and coverage of mass drug administration program against soil transmitted helminth infection in bangladesh an implementation research |
| url | http://www.sciencedirect.com/science/article/pii/S1876034118301539 |
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