AUTHOR=Muchiri Geoffrey , Okwii Moses , Bukuluki Paul , Willems Johan , Amanyi-Enegela Juliana A. , Yibi Makoy , Sankar Girija 

TITLE=Challenges and strategies for the uptake of mass drug administration among pastoralist communities in South Sudan

JOURNAL=Frontiers in Tropical Diseases

VOLUME=Volume 4 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/tropical-diseases/articles/10.3389/fitd.2023.1007480

DOI=10.3389/fitd.2023.1007480

ISSN=2673-7515

ABSTRACT=Mass Drug Administration (MDA) with preventive chemotherapy medicines to control and eliminate Neglected Tropical Diseases (NTDs) requires the active participation of communities living with or at risk of NTDs. Despite considerable progress by national control and elimination programmes, achieving consistent and sustainable treatment campaigns that reach pastoralist communities remain challenging, and delay the achievement of disease elimination goals. The challenges with treatment access to such communities also hinder the achievement of the Sustainable Development Goals’ vision of Leaving No One Behind. Elimination targets cannot be achieved if significant proportions of endemic populations such as pastoralists are missed out during treatment campaigns. In South Sudan, close to 70% of the population is categorized as pastoralist with previous data on MDA showing low access and acceptance, and inconsistent treatment coverages. To address this challenge, a cross-sectional study design was conducted in five counties with 239 pastoralist community respondents participating in in-depth interviews, Key Informant Interviews and Focus Group Discussions. 
Our findings show that in the pastoralist communities, high mobility, lay perceptions about the causes of NTDs and their treatment methods, limited awareness about the MDA and suboptimal health seeking behaviors were the major factors that limited accessibility and participation. The results suggest that improved uptake of MDA in these communities may be achieved through proper timing of treatment campaigns in congruence with the pastoralists’ seasonal migration patterns, involvement of pastoralist leaders during planning and social mobilization activities, engagement of community members as community drug distributors (CDDs), use of participatory behavior change approaches to design NTD interventions and by addressing the negative perceptions around the medicines including those around drug expiry, drugs causing impotence and associated side effects. Results from this study could guide National Programmes to address the challenges of treatment campaigns through enhanced involvement and representation of pastoralist communities.