Integrating Social and Behavior Change Communication into Mass Drug Administration Campaigns for Neglected Tropical Diseases: Insights and Best Practices from Jimma, Ethiopia

Zewdie Birhanu¹Sudhakar Morankar¹Daba Abdissa^1,2*Gelila Abraham¹Gebeyehu Bulcha³Teshome Shiferaw³Nimona Berhanu¹Firanbon Teshome¹Hirpa Miecha⁴Yohannes Kebede¹

• ¹Jimma University, Jimma, Ethiopia
• ²Department of Biomedical sciences, Jimma University, Jimma, Ethiopia
• ³Jimma Zonal health office, Jimma, Ethiopia
• ⁴Oromia Regional Health Bureau, Addis Ababa, Ethiopia

Background: Neglected tropical diseases (NTDs) remain a significant public health concern despite control efforts. Current control strategies rely heavily on mass drug administration (MDA), often overlooking complementary interventions like social and behavior change communication (SBCC). Given the complexity of behavior and its role in intervention uptake, this study explored experiences, best practices, and lessons learned from integrating a tailored SBCC approach into MDA campaigns in Jimma, Ethiopia. Method: A descriptive qualitative study was conducted following the implementation of SBCC integrated into two MDA campaign for target NTDs (OV and STH) between June and September 2022 in Jimma, Ethiopia. Purposive sampling was used to select participants from community members and stakeholders involved in the implementation of the project. A total of 4 focus group discussions, five expert group discussions and 10 key informant interviews were conducted. Guided by the RE-AIM framework, data were collected through four focus group discussions, five expert group discussions, and ten key informant interviews. The data analyses were facilitated by Atlas.ti version 7.1.5. Result: The study found that the intervention successfully reached diverse community groups through home visits, religious leaders, schools, and IEC materials, raising awareness and demand for MDA services. SBCC was integrated at key touch points, such as community registration, where early hygiene and NTD prevention education ensured informed participation. Community mobilization efforts, including local leaders and megaphones, expanded message reach, while schools and drug distributors amplified outreach and reinforced adherence. The approach was highly accepted, with stakeholders supporting its long-term sustainability and scale-up. However, challenges such as limited time, human resource constraints, and operational workload affected full integration and various adaptive strategies, helped improve implementation. Conclusion: Integrating SBCC into MDA campaigns showed strong potential in enhancing community engagement and improving treatment coverage in a context with behavioral and social barriers. While not universally required, SBCC may serve as a strategic complement in settings facing such challenges. The findings provide practical insights for guiding the context-specific application of SBCC to strengthen the effectiveness and sustainability of NTD interventions.