South Sudan is endemic for all preventive chemotherapy neglected tropical diseases, and counties including Awerial, Kapoeta North and Kajo-Keji face persistent transmission and high absenteeism and refusal rates for mass drug administration (MDA). To identify barriers, we conducted a mixed-methods root cause analysis (combining a quantitative KoboToolbox survey with focus group discussions and key informant interviews), using WI-HER's identify, design, apply/assess, record, and expand (iDARE) methodology with gender equity and social inclusion (GESI) at its core. Fundamental to our approach, we trained community-selected influencers (local leaders and respected community figures) in GESI principles and behavior change techniques, supporting them to co-design and implement locally contextualized solutions. Following influencer-led engagement in Awerial County, cohort members demonstrated a 90.9% improvement in MDA uptake. This pilot project demonstrates that sustainable increases in MDA coverage require a community-grounded approach that integrates localized barrier analysis, GESI-informed influencer training and ongoing community engagement.
BT - International health C1 - https://www.ncbi.nlm.nih.gov/pubmed/42429043 DA - 07/2026 DO - 10.1093/inthealth/ihag040 J2 - Int Health LA - ENG M3 - Article N2 -South Sudan is endemic for all preventive chemotherapy neglected tropical diseases, and counties including Awerial, Kapoeta North and Kajo-Keji face persistent transmission and high absenteeism and refusal rates for mass drug administration (MDA). To identify barriers, we conducted a mixed-methods root cause analysis (combining a quantitative KoboToolbox survey with focus group discussions and key informant interviews), using WI-HER's identify, design, apply/assess, record, and expand (iDARE) methodology with gender equity and social inclusion (GESI) at its core. Fundamental to our approach, we trained community-selected influencers (local leaders and respected community figures) in GESI principles and behavior change techniques, supporting them to co-design and implement locally contextualized solutions. Following influencer-led engagement in Awerial County, cohort members demonstrated a 90.9% improvement in MDA uptake. This pilot project demonstrates that sustainable increases in MDA coverage require a community-grounded approach that integrates localized barrier analysis, GESI-informed influencer training and ongoing community engagement.
PY - 2026 SP - 1 EP - 6 T2 - International health TI - Engaging community influencers to increase mass drug administration uptake for neglected tropical diseases in South Sudan. UR - https://academic.oup.com/inthealth/advance-article-pdf/doi/10.1093/inthealth/ihag040/68746003/ihag040.pdf SN - 1876-3405 ER -