Monitoring of the National Mass Drug Administration Campaign for Lymphatic Filariasis Elimination in Narmada District, Gujarat: An Experience

This study evaluates MDA campaign in Gujarat for lymphatic filariasis elimination in the Narmada district. While ashram schools achieved 95% coverage, household compliance reached only 75% due to work conflicts, and migrant workers showed 80% uptake with mop-up challenges. Key barriers included medical condition-related refusals (60%), fear of side effect of medication (30%), and documentation gaps (40%). Implementation challenges involved poor timing (missing 25% workers), exclusion of commercial sectors, and weak coordination.  Successful institutional delivery models contrasted with gaps requiring: 1) adjusted distribution timings, 2) targeted counselling for chronic patients, 3) workplace-based MDA, and 4) enhanced digital IEC in local dialects. The findings emphasise the need for improved microplanning, real-time monitoring, and private-sector integration.  These results demonstrate that tailored approaches targeted working populations, migrants, and comorbid patients can significantly improve compliance. The study provides actionable recommendations to strengthen MDA implementation, supporting India's 2027 elimination target through context-specific strategies that address ground-level challenges while leveraging successful institutional models.