Rapid ethnography and participatory Iwk techniques increase onchocerciasis mass drug administration treatment coverage in Benin: a difference-in-differences analysis

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AuteurBENON MONRA, ABDOULAYE
AuteurRUBIN MEANS, ARIANNA
AuteurSAMBIENI, N KOUE EMMANUEL
AuteurAVOKPAHO, EURIPIDE
AuteurKPATINVOH, FIFAME AUBIERGE EUDOXIE
AuteurBARDOSH, KEVIN
AuteurIBIKOUNLE, MOUDACHIROU
Date d'ajout2026-06-02T16:06:57Z
Date de disponibilite2026-06-02T16:06:57Z
Date de publication2023
ResumeBackground Onchocerciasis, a neglected tropical disease (NTD) that causes blindness, is controlled via mass drug administration (MDA) where entire endemic communities are targeted with preventative chemotherapeutic treat¬ment. However, in many settings, MDA coverage remains low. The purpose of this project was to determine if engag¬ing communities in the development of implementation strategies improves MDA coverage. Methods This study took place in an intervention and a control commune in Benin, West Africa. We conducted rapid ethnography in each commune to learn about community member perceptions of onchocerciasis, MDA, and opportunities to increase MDA coverage. Findings were shared with key stakeholders and a structured nominal group technique was used to derive implementation strategies most likely to increase treatment coverage. The implemen¬tation strategies were delivered prior to and during onchocerciasis MDA. We conducted a coverage survey within 2 weeks of MDA to determine treatment coverage in each commune. A difference-in-differences design was used to determine if the implementation package effectively increased coverage. A dissemination meeting was held with the NTD program and partners to share findings and determine the perceived acceptability, appropriateness, and feasibil¬ity of implementing rapid ethnography as part of routine program improvement. Results During rapid ethnography, key barriers to MDA participation included trust in community drug distributors, poor penetration of MDA programs in rural or geographically isolated areas, and low demand for MDA among specific sub-populations driven by religious or socio-cultural beliefs. Stakeholders developed a five-component implementa¬tion strategy package, including making drug distributor trainings dynamic, redesigning distributor job aids, tailoring community sensitization messages, formalizing supervision, and preparing local champions. After implementing the strategy package, MDA coverage increased by 13% (95% CI: 11.0-15.9%) in the intervention commune relative to the control commune. Ministry of Health and implementing partners found the approach to be largely accept¬able and appropriate; however, there was mixed feedback regarding the feasibility of future implementation of rapid ethnography. Conclusions Implementation research conducted in Benin, and indeed throughout sub-Saharan Africa, is often implemented in a top-down manner, with both implementation determinants and strategies derived in the global North. This project demonstrates the importance of participatory action research involving community members and implementers to optimize program delivery.
Autre identifiantBECDB-13820
URIhttps://dspace.uac.bj/handle/123456789/11814
Languefr
Fait partie deBMC RESEARCH NOTES
SujetParticipatory action research
SujetRapid ethnography
SujetNeglected tropical diseases
SujetMass drug administration
SujetBénin
TitreRapid ethnography and participatory Iwk techniques increase onchocerciasis mass drug administration treatment coverage in Benin: a difference-in-differences analysis
TypeArticle

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