斐济全国疥疮大规模药物管理 (MDA) 计划的可接受性:基于访谈的定性研究

IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES The Lancet Regional Health: Western Pacific Pub Date : 2024-09-04 DOI:10.1016/j.lanwpc.2024.101194
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引用次数: 0

摘要

背景斐济是全球报告疥疮发病率最高的国家之一。大规模用药(MDA)被认为是控制疥疮的潜在有效策略,但从接受和实施疥疮 MDA 计划的人的角度来看,斐济和全球对 MDA 的可接受性仍未进行充分的探讨。参与者包括斐济中部和西部分区的 44 名社区成员和 12 名关键信息提供者。2023 年 8 月和 9 月进行了半结构化面对面访谈和虚拟访谈。我们采用了解释性研究方法,并使用演绎和归纳技术对数据进行了分析。促进因素包括先前的疥疮经历和对 MDA 潜在健康益处的了解、社区对 MDA 的态度和邻居的坚持做法、社区领袖对 MDA 的认可、社区咨询和社区宣传,以及当地主要信息提供者在规划和实施过程中的参与。障碍包括对 MDA 运动缺乏信任、宗教信仰、社区宣传的范围有限,以及在城市地区实施 MDA 所面临的挑战。研究发现了影响 MDA 实施和可接受性的各种社会结构因素。未来的MDA项目将受益于广泛的社区宣传、量身定制的城市和农村MDA设计和实施方法,以及社区参与MDA项目的共同设计和实施。
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Acceptability of a nationwide scabies mass drug administration (MDA) program in Fiji: a qualitative interview-based study

Background

Fiji has among the highest global reported prevalence of scabies. Mass drug administration (MDA) has been identified as a potentially effective strategy to control scabies, but acceptability of MDA from the perspectives of people receiving and delivering scabies MDA programs remains underexplored in Fiji and globally.

Methods

A qualitative study was conducted after completion of the national MDA campaign. Participants included 44 community members and 12 key informants across the Central and Western Divisions of Fiji. Semi-structured face-to-face and virtual interviews were conducted in August and September 2023. An interpretive research approach was adopted, and data were analysed using deductive and inductive techniques.

Findings

We identified several barriers and facilitators to scabies MDA acceptability. Facilitators included prior experiences of scabies and knowledge of the potential health benefit of MDA, community attitudes to MDA and neighbours’ adherence practices, endorsement of MDA by community leaders, community consultation and exposure to community sensitisation, and involvement of local key informants during planning and implementation. Barriers included a lack of trust in MDA campaigns, religious beliefs, limited reach of community sensitisation, and challenges to implementing MDA in urban locations.

Interpretation

This is the first qualitative study documenting acceptability of a nationwide scabies-MDA globally. It identified diverse socio-structural factors that influenced MDA implementation and acceptability. Future MDA programs could benefit from widespread community sensitisation, tailored approaches to urban and rural MDA design and delivery, and the inclusion of communities in the co-design and implementation of MDA programs.

Funding

The National Health and Medical Research Council (NHMRC) investigator grant—LR and the Macquarie Group Foundation 50th Celebration Awards–AS.

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来源期刊
The Lancet Regional Health: Western Pacific
The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health
CiteScore
8.80
自引率
2.80%
发文量
305
审稿时长
11 weeks
期刊介绍: The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.
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