Insecurity as a driver of migration, and its impact on the uptake of neglected tropical diseases preventive chemotherapy interventions in Kaduna State, Nigeria

Background

Neglected Tropical Diseases (NTDs) are diseases that are associated with poverty and cause various degrees of socio-economic devastation in Nigeria. Equitable access to interventions is important to achieve elimination of any public health disease. Increasing migration due to insecurity in Kaduna State disrupts access to mass administration of medicines (MAM) by internally displaced persons (IDPs). This study aims to investigate insecurity as a driver of migration and its impact on preventive chemotherapy NTDs interventions uptake in Kaduna State from 2019 to 2022.

Methods

A mixed methods study design comprising household surveys, migration form, in-depth interviews and focus group discussions using a community-based participatory research approach was employed. The participants for the surveys were 5–70 years; focus group youth 18–49 years, elders 50–70 years; while interviews were 35–60 years. Quantitative data were analysed with descriptive statistics and logistic regression using SPSS version 26 and qualitative data analysed with directed content analysis using NVivo software version 12 Plus. Quantitative and qualitative data were integrated to avoid bias.

Results

Seven hundred and two migrants/IDPs (mean 33.4 years, SD 15.1), 893 household survey respondents (mean 28.8 years, SD 16.5), and 115 interviews/focus group discussions (mean 46.7 years, SD 12.3) formed this study. Low uptake of interventions among migrants/IDPs was recorded (OR = 0.008; P  < 0.001). Qualitative results highlighted low awareness of interventions at the community level, shortage of medicines, community drug distributor attrition, late reporting of interventions as some of the factors affecting uptake of interventions.

Conclusion

Neglecting IDPs/migrants in the planning and implementation of interventions will reduce uptake of interventions and delay elimination of NTDs in Nigeria. Efforts should be made to reach and treat migrants/IDPs population, create a robust census system to document all IDPs/migrants and to ensure sufficiency of donated medicines.