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Table 2 Summary of CHW experiences and perceptions on MDA in an urban setting

From: Experiences and perspectives of community health workers from implementing treatment for schistosomiasis using the community directed intervention strategy in an informal settlement in Kisumu City, western Kenya

What worked well/opportunities

 • CHW familiarity with households led to warm reception

 • Good knowledge of intervention area by CHWs

 • High demand for drugs in the final year of treatment

 • Effective community mobilization

 • Opportunity to integrate MDA with other health interventions

 • Presence of CHWs and their supervisory structure, and points of referral for serious side effects

Challenges

 • Fear of side effects, size of tablet and misconceptions regarding treatment

 • Unrelated death and the associated negative publicity by the media

 • Religious beliefs and mistrust of interventions

 • Insufficient time and absence of community members during the MDA exercise

 • Difficulty in directly observing treatment

 • Unsanitary environmental conditions, insecurity and inaccessibility

 • Demand for incentives by community members to take drugs

Recommendations by CHWs

 • Increase in duration for conducting MDA and number of CHWs

 • Provision of incentives during the MDA exercise

 • Community sensitization through media

 • Incorporation of continuous Health education messaging in MDA exercises