Strengthening Mass Drug Administration (MDA) Through Community Dialogues

James Tibenderana and colleagues of the Malaria Consortium in the United Kingdom are adapting a "community dialogue" approach to build trust between communities and the health system in Mozambique in order to boost participation in Mass Drug Administration (MDA) programs against neglected tropical diseases. Low participation in MDA programs is thought to be caused by negative local perceptions of these diseases and a limited understanding of the goals of MDAs. By engaging with communities to address their misconceptions and fill knowledge gaps, they aim to align the goals of the community with those of MDAs to improve participation. In Phase I, Sylvia Meek performed a pilot study focused on schistosomiasis and trained 157 community members in four, resource-poor districts of the Nampula province to act as dialogue facilitators. They developed materials such as flip charts for the facilitators to inform individuals, including those who are illiterate, during organized sessions about the causes, symptoms, prevention, and control of schistosomiasis. Their study increased awareness and knowledge, and willingness to participate in MDAs, and also mobilized communities to implement preventative measures such as building latrines. In Phase II, James Tibenderana and colleagues will adapt their approach to maximize its impact and address the challenges identified in Phase I. Two additional diseases will be included, and they will train more facilitators. The refined approach will then be tested over a longer period in the same region as Phase I, and involve more extensive evaluation to ultimately test its impact on MDA participation.