Integration of health education intervention to improve the compliance to mass drug administration for soil-transmitted helminths infection in Bangladesh: An implementation research

Abstract

Introduction In Bangladesh, the prevention and control strategy of soil-transmitted helminthiasis (STHs) is based on the mass drug administration (MDA) program. Despite bi-annual MDA since 2008, the reported compliance is still below the target, and the STH prevalence is high in several areas. This study was done to assess the feasibility and barriers of integrating health education (HE) intervention to achieve the target MDA compliance in the local context of Bangladesh. Materials and methods A mixed-method study, utilizing PRISM (Practical Robust Implementation Sustainability Model) framework, was conducted between July 2017 to March 2018 in Dhaka and Sylhet divisions of Bangladesh. A total of 640 school-aged children selected from four different schools were divided into intervention and control groups. Eight focus group discussions (FGDs) and eight in-depth interviews (IDIs) were also conducted among 56 adults, including parents of school-aged children, school teachers, and health officers. Results Quantitative findings revealed that HE intervention had a significant role ( P < .05) to improve the mean knowledge score in the intervention group (3.35) compared to the control group (0.29). STH preventive behaviours and MDA participating attitudes were also significantly increased in the intervention group ( P < .05) compared to the control group. Some of the major barriers associated with HE integration identified in the qualitative study were budget deficiencies, inadequate training of program implementers, and information gaps. In contrast, the school environment and positive community attitudes were observed as supportive factors for the integration of HE. Conclusion Increased knowledge score and behaviour changes due to HE intervention demonstrated in this study hint that integration of HE with MDA is feasible and can be promising to promote MDA compliance and to reduce STH prevalence in this setting. However, the allocation of adequate budget, as well as coordination and collaboration with local political context, should be addressed for the sustainability of integration.

Health workers’ perspectives on school-based mass drug administration control programs for soil-transmitted helminthiasis and schistosomiasis in Ogun State, Nigeria

“…This resistance often stems from false beliefs, including the misconception that the treatment is lethal or is aimed at sterilization. Our findings highlighted similar STH and SCH misperceptions from studies in Nigeria, Bangladesh, and the Philippines [ 2 , 21 , 22 , 45 ]. These misconceptions can impede parents’ willingness to allow their children to participate and undermine the success of health programs.…”

“…Health workers facilitate MDA by distributing medication, educating communities, and monitoring progress to control and eliminate diseases effectively. Therefore, the health worker's perceptions will provide insights into the challenges and enablers of the MDA control programs and significantly improve the programs, thus aiding in achieving the NTD 2030 goals [21][22][23].…”

“The Magic Glasses Philippines”: a cluster randomised controlled trial of a health education package for the prevention of intestinal worm infections in schoolchildren

“…The integration of health education in school-based deworming programs is recommended by WHO [6] to reduce STH infections and re-infection risks through hygiene awareness and behaviour modifications. As shown in a number of studies, health education strategies are associated with increased knowledge [19−24] and acceptability of deworming [21], and uptake and maintenance of WASH interventions. [25] In addition, the positive impact of health education intervention on STH infections in children has been demonstrated in some of these reports.…”

Participatory Health Cadre Model to Improve Exclusive Breastfeeding Coverage with King’s Conceptual System

“…This model results in the active involvement of health cadres in the communities they serve, namely breastfeeding mothers, to enhance understanding and acceptance of exclusive breastfeeding practices. 113 This aligns with the application of participation theory, emphasizing the involvement of individuals in various activities and emphasizing the importance of a strategy that utilizes local, spatial, and bottom-up resources in monitoring breastfeeding mothers to achieve exclusive breastfeeding, thereby fulfilling government programs without sacrificing personal interests. This research applies interpersonal theory by employing an approach to ultimately achieve common goals through behavior or actions, such as mentoring.…”