02587nas a2200349 4500000000100000008004100001260004300042653001600085653001100101653002900112653003900141653001300180653001100193100001400204700001200218700001500230700001300245700002100258700001400279700002100293700001600314700001100330700001700341700001200358700001700370700001700387245012300404856011000527300001100637520156400648022002502212 2026 d c09/2026bOxford University Press (OUP)10aElimination10aEquity10aMass drug administration10aNeglected tropical diseases (NTDs)10aTrachoma10aUganda1 aSsegawa E1 aChhan D1 aKarlsson C1 aMarwas P1 aHarb Faramand T1 aBackers S1 aNturanemigisha H1 aMubangizi A1 aOpon R1 aKyarisiima H1 aPeter A1 aHabomujuni B1 aSutherland E00aRipple Effects Mapping of a gender equity and social inclusion behaviour change activity in Uganda’s trachoma effort uhttps://academic.oup.com/inthealth/advance-article-pdf/doi/10.1093/inthealth/ihag086/71393584/ihag086.pdf a1 - 113 a
Background
Uganda’s trachoma program has faced persistent challenges in achieving adequate preventive medicine coverage. To address these, the Ministry of Health applied Ripple Effects Mapping (REM) to assess a gender equity and social inclusion (GESI) behaviour change activity (BCA). To our knowledge, this represents one of the first documented applications of REM to a neglected tropical disease (NTD) program.
Methods
Seven REM workshops were conducted with government officials, health staff and community members. Facilitators guided participants to identify the BCA’s inputs, outputs and intended and unintended outcomes. Findings were consolidated and analysed using mind-mapping software.
Results
Workshop participants reported that the BCA increased access, demand and uptake of trachoma preventive medicine among populations missed in previous campaigns. Workshops also demonstrated diversification of campaign stakeholders; improved water, sanitation and hygiene and prevention practices; and stronger social accountability between communities and local government.
Conclusion
REM provided the Uganda NTD program with a participatory way to validate intended results and uncover additional effects of a trachoma BCA. Findings from the workshops point to REM’s potential value for informing investment, replication and strategy to accelerate trachoma elimination in Uganda and similar settings.
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