Beatriz Galatas1,2, Hoticha Nhantumbo1, Rodolfo Soares3, Helder Djive1, Ilda Murato1, Wilson Simone1, Eusebio Macete1,4, N Regina Rabinovich2,5, Pedro Alonso1,2, Baltazar Candrinho6, Francisco Saúte1, Pedro Aide1,7, Khátia Munguambe1,8. 1. Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique. 2. ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain. 3. Center for International Studies (CEI-IUL), Lisbon, Portugal. 4. National Directorate of Health, Ministry of Health, Maputo, Mozambique. 5. Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America. 6. National Malaria Control Programme (NMCP), Ministry of Health, Maputo, Mozambique. 7. National Institute of Health, Ministry of Health, Maputo, Mozambique. 8. Faculdade de Medicina, Universidade Eduardo Mondlane (UEM), Maputo, Mozambique.
Abstract
BACKGROUND: This study aimed to capture the acceptability prior to, during and after the implementation of the first year of MDA rounds conducted under the Magude project, a malaria elimination project in southern Mozambique. METHODS: This was a mixed-methods study, consisting of focus group discussions (FGDs) prior to the implementation of MDA rounds (September 2015), non-participant observations (NPOs) conducted during the MDA rounds (November 2015 -beginning of February 2016), and semi-structured interviews (SSIs) after the second round (end of February 2016). Community leaders, women in reproductive age, general members of the community, traditional healers and health professionals were recruited to capture the opinions of all representing key members of the community. A generic outline of nodes and codes was designed to analyze FGDs and SSI separately. Qualitative and quantitative NPO information was analyzed following a content analysis approach. FINDINGS: 222 participants took part in the FGDs (n = 154), and SSIs (n = 68); and 318 household visits during the MDA underwent NPOs. The community engagement campaign emerged throughout the study stages as a crucial factor for the acceptability of MDAs. Acceptability was also fostered by the community's general will to cooperate in any government-led activity that would reduce malaria burden, the appropriate behavior and knowledge of field workers, or the fact that the intervention was available free of charge to all. Absenteeism of heads of households was identified as the main barrier for the success of the campaign. The most commonly reported factors that negatively affected acceptability were the fear of adverse events, rumors of deaths, being unable to drink alcohol while taking DHAp, or the fear to take DHAp while in anti-retroviral treatment. Pregnancy testing and malaria testing were generally well accepted by the community. CONCLUSION: Magude's community generally accepted the first and second antimalarial MDA rounds, and the procedures associated to the intervention. Future implementation of antimalarial MDAs in southern Mozambique should focus on locally adapted strategies that engage the community to minimize absenteeism and refusals to the intervention.
BACKGROUND: This study aimed to capture the acceptability prior to, during and after the implementation of the first year of MDA rounds conducted under the Magude project, a malaria elimination project in southern Mozambique. METHODS: This was a mixed-methods study, consisting of focus group discussions (FGDs) prior to the implementation of MDA rounds (September 2015), non-participant observations (NPOs) conducted during the MDA rounds (November 2015 -beginning of February 2016), and semi-structured interviews (SSIs) after the second round (end of February 2016). Community leaders, women in reproductive age, general members of the community, traditional healers and health professionals were recruited to capture the opinions of all representing key members of the community. A generic outline of nodes and codes was designed to analyze FGDs and SSI separately. Qualitative and quantitative NPO information was analyzed following a content analysis approach. FINDINGS: 222 participants took part in the FGDs (n = 154), and SSIs (n = 68); and 318 household visits during the MDA underwent NPOs. The community engagement campaign emerged throughout the study stages as a crucial factor for the acceptability of MDAs. Acceptability was also fostered by the community's general will to cooperate in any government-led activity that would reduce malaria burden, the appropriate behavior and knowledge of field workers, or the fact that the intervention was available free of charge to all. Absenteeism of heads of households was identified as the main barrier for the success of the campaign. The most commonly reported factors that negatively affected acceptability were the fear of adverse events, rumors of deaths, being unable to drink alcohol while taking DHAp, or the fear to take DHAp while in anti-retroviral treatment. Pregnancy testing and malaria testing were generally well accepted by the community. CONCLUSION: Magude's community generally accepted the first and second antimalarial MDA rounds, and the procedures associated to the intervention. Future implementation of antimalarial MDAs in southern Mozambique should focus on locally adapted strategies that engage the community to minimize absenteeism and refusals to the intervention.
Authors: Hugh J W Sturrock; Michelle S Hsiang; Justin M Cohen; David L Smith; Bryan Greenhouse; Teun Bousema; Roly D Gosling Journal: PLoS Med Date: 2013-06-18 Impact factor: 11.069
Authors: Andy Guise; T Charles Witzel; Sema Mandal; Caroline Sabin; Tim Rhodes; Anthony Nardone; Magdalena Harris Journal: BMC Infect Dis Date: 2018-06-19 Impact factor: 3.090