How community engagement strategies shape participation in mass drug administration programmes for lymphatic filariasis: The case of Luangwa District, Zambia

BACKGROUND: The success of the global strategy to eliminate lymphatic filariasis (LF) through mass drug administration (MDA) campaigns is dependent on meeting high coverage levels over long periods of time. Community engagement plays a critical role in driving coverage and involvement of local communities in MDA for LF. This study explored how community engagement approaches used in MDA for LF shape participation in the programme, with a view of proposing effective engagement strategies. METHODS: The study was conducted in Luangwa, a rural District of Lusaka province, Zambia. An exploratory qualitative case study approach was employed. A total of nine focus group discussions, six in-depth and seven key informant interviews were conducted with various participants that included; community members, traditional leaders and programme managers, respectively. Data were analysed using a thematic approach, aided by NVivo 10 software. RESULTS: Three core thematic areas emerged from the data as priority focus areas for programme planners and implementers in designing effective community engagement strategies that facilitate participation. Firstly, employing of partnership approaches through adequate and timely engagement of traditional, government and non-governmental organisation structures. Secondly, use of appropriate and innovative health education initiatives to disseminate information about the programme. Thirdly, addressing context specific programme implementation barriers affecting community engagement in MDA for LF. CONCLUSION: Facilitating participation in MDA for LF will require designing and implementing effective community engagement strategies that take into account local context, but also seek to explore all avenues of maximizing participation for improved coverage levels. MDA for LF implementation teams should systematically consider the identified factors and seek to incorporate them in their implementation plans.