ArticleParasites & vectors2021
Factors influencing mass drug administration adherence and community drug distributor opportunity costs in Liberia: a mixed-methods approach.
Article in Parasites & vectors, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 25 citations in OpenAlex.
- Article
- In silico design of a multi-epitope pan vaccine targeting Schistosoma species.Genomics & informatics · 2025Article
- Current perspectives in the epidemiology and control of lymphatic filariasis.Clinical microbiology reviews · 2025Review
- Exploring the value of community engagement activities within a participatory action research study to improve care for people affected by skin neglected tropical diseases in Liberia.Research involvement and engagement · 2025Article
- Intestinal schistosomiasis in remote areas of Southwest Ethiopia, a target region for large-scale mass drug administration.Scientific reports · 2025Article
- Economic evaluations of community health worker programs focussed on neglected tropical diseases in low- and middle-income countries (2015-2024): A scoping literature review.PLOS global public health · 2025Article
- Community preferred drug delivery approaches for pilot roll-out of a potential novel paediatric schistosomiasis treatment option in two endemic counties of Kenya: A mixed methods study.PLOS global public health · 2024Article
- Article
- Perceptions and acceptability of co-administered albendazole, ivermectin and azithromycin mass drug administration, among the health workforce and recipient communities in Ethiopia.PLoS neglected tropical diseases · 2023Article
- Rapid ethnography and participatory techniques increase onchocerciasis mass drug administration treatment coverage in Benin: a difference-in-differences analysis.Implementation science communications · 2023Article
- Optimal Interruption of P. vivax Malaria Transmission Using Mass Drug Administration.Bulletin of mathematical biology · 2023Article
- Job satisfaction among community drug distributors in the Mass Drug Administration programme in Nigeria: a cross-sectional study.International health · 2023Article
- A Post-Lockdown Assessment of Albendazole Treatment Coverage in Mass Drug Administration Campaigns Implemented Before and During COVID-19 Pandemic in Ekiti, Southwest Nigeria.International journal of public health · 2023Article
- Financing care for Severe Stigmatizing Skin Diseases (SSSDs) in Liberia: challenges and opportunities.International journal for equity in health · 2022Article
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundPreventive chemotherapy delivered via mass drug administration (MDA) is essential for the control of neglected tropical diseases (NTDs), including lymphatic filariasis (LF), schistosomiasis and onchocerciasis. Successful MDA relies heavily on community drug distributor (CDD) volunteers as the interface between households and the health system. This study sought to document and analyse demand-side (households) and supply-side (health system) factors that affect MDA delivery in Liberia.
methodsWorking in two purposively selected counties, we conducted a household MDA access and adherence survey; a CDD survey to obtain information on direct and opportunity costs associated with MDA work; an observational survey of CDDs; and key informant surveys (KIS) with community-level health workers. Data from the CDD survey and Liberian minimum wage rates were used to calculate the opportunity cost of CDD participation per MDA round. The observational data were used to calculate the time spent on individual household-level tasks and CDD time costs per house visited. KIS data on the organisation and management of the MDA in the communities, and researcher reflections of open-ended survey responses were thematically analysed to identify key demand- and supply-side challenges.
resultsMore respondents were aware of MDA than NTD in both counties. In Bong, 39% (103/261) of respondents reported taking the MDA tablet in the last round, with "not being informed" as the most important reason for non-adherence. In Maryland, 56% (147/263) reported taking MDA with "being absent" at the time of distribution being important for non-adherence. The mean cost per CDD of participating in the MDA round was -$11.90 (median $5.04, range -$169.62 to $30.00), and the mean time per household visited was 17.14 min which equates to a mean opportunity cost of $0.03 to $0.05 per household visited. Thematic analysis identified challenges, including shortages of and delays in medicine availability; CDD frustration over costs; reporting challenges; and household concerns about drug side effects.
conclusionsImproved adherence to MDA and subsequent elimination of NTDs in Liberia would be supported by an improved medicine supply chain, financial compensation for CDDs, improved training, healthcare workforce strengthening, greater community involvement, capacity building, and community awareness.
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