Scholarlink

Background <p>The World Health Organization (WHO) recommends Mass Drug Administration (MDA) to reduce malaria transmission in low-transmission settings, with a target coverage of at least 80%. To maximize impact, the development of effective and sustainable programmatic implementation strategies is essential. Between December 2022 and February 2023, two rounds of programmatic MDA (pMDA) were implemented in Chidenguele, in Gaza province, Mozambique. The target population was approximately 59,271 individuals. Door-to-door drug distribution, using dihydroartemisinin-piperaquine, was guided by satellite imagery-based mapping.</p> Methods <p>A mixed-methods evaluation was conducted to assess operational performance —including acceptability, appropriateness, coverage, feasibility, fidelity, and adoption— using a community household survey (<i>n</i> = 770), a health staff survey (<i>n</i> = 28), and field observations (<i>n</i> = 149).</p> Results <p>Among household survey participants eligible for medication during round 2, 96,2% (607/631) <i>accepted</i> to participate in the pMDA. All health staff survey participants and 91,3% (703/770) of household survey participants considered taking antimalarials while asymptomatic to be an acceptable preventive measure. All health staff survey participants (28/28) and 84,1% (648/770) of household survey participants felt the intervention was <i>appropriate</i> for reducing malaria transmission in the community. Programmatic or contact coverage (proportion of survey participants that received pMDA treatment) reached 73,9% (569/770), while operational coverage (proportion of those present at the time of the intervention that received pMDA treatment) was 90,2% (569/631). All health staff survey participants (28/28) considered the pMDA implementation strategy <i>feasible</i> to implement. In terms of <i>fidelity</i>, direct observations of pMDA household visits showed that pMDA distribution teams correctly explained the purpose of the visit in 74,5% (111/149) of interactions, requested verbal consent in 86,6% (129/149), and emphasized the importance of completing the treatment in 60,4% (90/149). Health staff survey participants showed strong willingness to <i>adopt</i> the procedures, with 86.0% (24/28) and 96.0% (27/28) expressing high commitment in rounds 1 and 2, respectively.</p> Conclusions <p>Despite the pMDA delivery strategy being implemented with good operational performance and being well accepted by the community and health staff, reaching the 80% coverage target remains challenging. Sustained collaboration and active engagement from communities, partners, and policymakers, and enhancement of some key outcomes, such as the fidelity of the implementation, are critical to improving coverage and ensuring the success of pMDA campaigns.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Operational performance of a programmatic mass drug administration campaign for malaria in southern Mozambique: a comprehensive mixed-methods evaluation of implementation outcomes

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月7日

查看全文
  • Laura Fuente-Soro,
  • Maria Tusell,
  • Jacopo Vecchio,
  • Amancio Nhangave,
  • Khalid Bapu,
  • Christina Riley,
  • Felisbela Materrula,
  • Mércia Dimene,
  • Samira Sibindy,
  • Baltazar Candrinho,
  • Pedro Aide,
  • Caterina Guinovart

摘要

Background

The World Health Organization (WHO) recommends Mass Drug Administration (MDA) to reduce malaria transmission in low-transmission settings, with a target coverage of at least 80%. To maximize impact, the development of effective and sustainable programmatic implementation strategies is essential. Between December 2022 and February 2023, two rounds of programmatic MDA (pMDA) were implemented in Chidenguele, in Gaza province, Mozambique. The target population was approximately 59,271 individuals. Door-to-door drug distribution, using dihydroartemisinin-piperaquine, was guided by satellite imagery-based mapping.

Methods

A mixed-methods evaluation was conducted to assess operational performance —including acceptability, appropriateness, coverage, feasibility, fidelity, and adoption— using a community household survey (n = 770), a health staff survey (n = 28), and field observations (n = 149).

Results

Among household survey participants eligible for medication during round 2, 96,2% (607/631) accepted to participate in the pMDA. All health staff survey participants and 91,3% (703/770) of household survey participants considered taking antimalarials while asymptomatic to be an acceptable preventive measure. All health staff survey participants (28/28) and 84,1% (648/770) of household survey participants felt the intervention was appropriate for reducing malaria transmission in the community. Programmatic or contact coverage (proportion of survey participants that received pMDA treatment) reached 73,9% (569/770), while operational coverage (proportion of those present at the time of the intervention that received pMDA treatment) was 90,2% (569/631). All health staff survey participants (28/28) considered the pMDA implementation strategy feasible to implement. In terms of fidelity, direct observations of pMDA household visits showed that pMDA distribution teams correctly explained the purpose of the visit in 74,5% (111/149) of interactions, requested verbal consent in 86,6% (129/149), and emphasized the importance of completing the treatment in 60,4% (90/149). Health staff survey participants showed strong willingness to adopt the procedures, with 86.0% (24/28) and 96.0% (27/28) expressing high commitment in rounds 1 and 2, respectively.

Conclusions

Despite the pMDA delivery strategy being implemented with good operational performance and being well accepted by the community and health staff, reaching the 80% coverage target remains challenging. Sustained collaboration and active engagement from communities, partners, and policymakers, and enhancement of some key outcomes, such as the fidelity of the implementation, are critical to improving coverage and ensuring the success of pMDA campaigns.