Social Mobilization and Compliance with Mass Treatment for Lymphatic Filariasis Elimination in Kenya

Abstract

This study aimed to establish the role of social mobilization in mass drug administration (MDA) uptake during the National Programme to Eliminate Lymphatic Filariasis (LF) in Kenya. MDA for LF based on diethylcarbamazine (DEC) and albendazole using community-based treatment approach has been conducted for three years (2003, 2005 and 2008) in Kwale and Malindi districts.

In each district, one high and one low, compliance locations were selected based on 2008 MDA data. From the four locations, nine villages were systematically sampled and a total of 965 randomly selected household heads interviewed. Sixteen focus group discussions with adult and youth male and female groups and separate in-depth interviews with eighty opinion leaders and eighty LF patients with clinical manifestations, purposively selected were conducted. Semi-structured interviews were held separately with fifteen community drug distributors, five health personnel and four LF coordinators also purposively selected.

The results showed that knowledge about MDA for LF was not significantly associated with compliance (P>0.05). Seventy three percent in low and 78% in high compliance villages knew about MDA. The most common source of MDA information given by 49% of respondents in high and 40% in low compliance villages were the community drug distributors (CDDs). The content of MDA information received influenced compliance (P< 0.001), 71% in high compared to 61% in low compliance villages received correct information. The frequency of receiving MDA information also influenced compliance (P< 0.001), 65.5% in high compared to 50% in low compliance villages received the correct information at least once before treatment. Opinion towards the source of MDA information was also associated with compliance, 46% in high compared to 43% in low compliance villages considered the source as adequate (P< 0.001).

The study results show that for MDA to be successful, information dissemination should be done by all stakeholders with the health personnel taking the lead role so that more adequate and factual content is relayed. Community sensitization and mobilization should be done repeatedly for all to get the information in good time to comply with treatment.

Keywords: Compliance; Lymphatic Filariasis; Mass Drug Administration; Social Mobilization