Acceptability and perceived barriers to reactive focal mass drug administration in the context of a malaria elimination program in Magude district, Southern Mozambique: A qualitative study

PLoS One. 2023 Mar 31;18(3):e0283160. doi: 10.1371/journal.pone.0283160. eCollection 2023.

Abstract

This study analysed acceptability and perceived barriers to reactive focal mass drug administration (rfMDA) among community members exposed to community engagement campaigns and malaria elimination interventions in Magude district, following mass drug administration (MDA) in the same district. The study used a formative qualitative study design, consisting of 56 semi-structured interviews with community members, including community leaders, household heads, women of reproductive age, members of the community and adolescents, 4 semi-structured interviews with community health workers, 9 semi-structured interviews with healthcare professionals; and 16 focus group discussions with the general adult population. Data were collected between June and September 2017. A content thematic analysis approach was used to analyse the data. The results of this study showed that rfMDA was accepted due to awareness about the intervention, experience of a previous similar programme, the MDA campaign, and due to favourable perceptions built on the believe that rfMDA would help to prevent, treat and eliminate malaria in the community. Perceived barriers to rfMDA include lack of access to accurate information, reluctance to take a pregnancy test, concern on drug adverse reactions, and reluctance to take antimalarial drugs without any symptom. In conclusion, the community found rfMDA acceptable for malaria intervention. But more community engagement is needed to foster community involvement and self-appropriation of the malaria programme elimination.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antimalarials* / therapeutic use
  • Community Health Workers
  • Female
  • Humans
  • Malaria* / drug therapy
  • Malaria* / prevention & control
  • Mass Drug Administration
  • Mozambique

Substances

  • Antimalarials

Grants and funding

The study reported in this paper was part of the Magude project. The Magude project (NCT02914145) was funded by the Bill and Melinda Gates Foundation and Obra Social “la Caixa” Partnership for the Elimination of Malaria in Southern Mozambique (OPP1115265). The Magude project was implemented by the Centro de Investigação em Saúde da Manhiça (CISM). CISM is supported by the Government of Mozambique and the Spanish Agency for International Development (AECID) for core funding, but the study reported in this paper did not receive any funding from the Government of Mozambique nor AECID, it was fully and solely funded by OPP1115265. The funders had no role in study design, data collection and data analysis, decision to publish, or preparation of the manuscript.