Literature: Why do people participate in mass antimalarial administration? Findings from a qualitative study in Nong District, Savannakhet Province, Lao PDR (Laos).

Image: A mass meeting in Tha Thay, Laos, explaining TME procedures using a poster (Adhikari et al. 2018)

This article draws on qualitative data to explore the factors that led to high population coverage (>87%) of mass drug administration (MDA) as part of targeted malaria elimination (TME)* in the Greater Mekong sub-region of South East Asia. TME encompasses a package of interventions including the strengthening of village malaria worker networks alongside MDA. Community engagement and education activities (including health education through theatre, posters, village meetings, and house-to-house visits) were undertaken to promote the uptake of MDA in target communities.

As a result of data collection through a range of qualitative methods (including observations, field notes, focus groups and semi-structured interviews), the article concludes that a combination of the following factors influenced participation in mass antimalarial administration:

• Community engagement to promote concept and rationale of MDA for asymptomatic malaria (in addition to baseline understandings of malaria as a health concern)
• Provision of free primary healthcare (as under normal circumstances poverty and distance affected access to healthcare)
• Familiarity with the rationale for blood testing and MDAs
• Partnering of research with local volunteers and authorities
• Building social relationships with community members that promoted trust
• Responsive approach to community engagement, whereby concerns were addressed promptly

*Targeted malaria elimination (TME) = “the presumptive treatment of an entire community to interrupt completely local malaria transmission” (Adhikari et al. 2017)

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