Social Factors Affecting Community Participation in Mass Drug Administration Programs to Eliminate Lymphatic Filariasis in Zimbabwe. A Case Study of Muzarabani District, Zimbabwe

Neglected Tropical Diseases (NTDs) continue to be common in Sub-Saharan Africa, with the region contributing to about 40% of the global burden. In Zimbabwe, Lymphatic Filariasis (LF) is one of the most common NTDs and the government and its health sector partners has committed to eliminate the disease and other NTDs. However, the Zimbabwe NTDs Master Plan (2023-2027) reports that transmission of LF in Zimbabwe is challenging to stop because elimination programs often fail to reach full community coverage. These elimination programs are implemented through Mass Drug Administrations (MDAs) where preventive chemotherapy is performed through administration of Albendazole and Ivermectin. The failure of MDA programs to reach everyone in affected areas is partly because of community members who deliberately not participate in the program. Therefore, this study aimed to investigate the social factors affecting community participation in MDA programs to eliminate LF in Zimbabwe. The study used a qualitative case study approach and was conducted in Muzarabani district, one of the areas most affected by LF. Using non-probability convenience sampling, fifteen participants were selected and engaged using semi-structured interviews and five key health personnel working in the district were purposively selected as key informants relevant for the study. Document analysis also complemented the study and the triangulated with interviews to ensure findings credibility. Thematic analysis was used to analyze data and findings were systematically presented in form of most emerging themes. The study found that community participation in MDA programs is affected by several social factors including myths surrounding drugs and vaccine, lack of comprehensive health information and education, history with previous MDA and other vaccination programs and religious beliefs. The study concluded that most of the identified factors stemmed significant gaps in comprehensive health information and education. It recommends that awareness raising, capacity building in health literacy and community engagement stand as the miracle medicine to counter the social factors imbedded in historical colonial prejudice, cultural norms and values presided by socio-religious contexts.