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Table 2 Summary of identified facilitators and barriers

From: A systematic review of factors that shape implementation of mass drug administration for lymphatic filariasis in sub-Saharan Africa

Structural or broad themes Emergent themes (number of studies)
Facilitators Barriers
Social mobilization/Community engagement/(Health education). Awareness creation through community led health education programmes (n = 3) [36, 37, 42]. Limited investment in appropriate timing, dissemination of accurate MDA for LF information (n = 3) [21, 38, 44].
Innovative and locally relevant means to conduct health education/modern and traditional approaches to H.E. (n = 4) [22, 36, 37, 39].  
Use of appropriate IEC materials for health education (n = 5) [22, 24, 36, 37, 42].
Involve key health systems representatives and local leaders in health education (n = 7)
[22, 23, 25, 34, 36, 37, 41]
Community drug distributors in MDA for LF implementation. Selection, training and financial incentives provided to CDDs (n = 5) [22, 25, 34, 35, 37, 44], and provision of mobile phones and other forms of motivation (n = 1) [45]. Limited number of CDDs to implement MDA for LF (n = 4) [22, 23, 25, 35].
Allocation of large number of household areas to CDDs for drug distribution (n = 4) [21, 35, 38, 44].
Political and health systems factors in MDA for LF implementation. Building of partnerships and collaborations (international and local), resulting in sustained political commitment to MDA for LF (n = 7) [22, 23, 36, 37, 40, 42, 43]. Major disease outbreaks may paralyze health systems and affect MDA for LF (n = 2) [33, 44]
Integration with existing health interventions (n = 4) [36, 37, 39, 42]  
Innovative resource mobilization strategies in environments totally lacking local resources (n = 1) [36]
Establishment of morbidity management programmes (n = 3) [39, 40, 43]
Adverse effects management during MDA for LF implementation (n = 6) [34, 36, 37, 39,40,41].
Population dynamics affecting MDA for LF Implementation.   Lack of clear geographical demarcations in MDA for LF implementation units (n = 2) [22, 23]
Rapid urbanization and employment seeking population migrations into MDA for LF implementation units (n = 2) [22, 23]
MDA for LF drug commodities and logistics supply.   Late delivery and procurement of MDA for LF drugs at community and international level (n = 3) [23, 36, 37].
Unsustainable and inappropriate drug delivery strategies for given settings (n = 4) [21, 23, 36, 37].