Abstract:
Background: In Kenya, the National School-Based Deworming Programme (NSBDP)
for soil-transmitted helminthes and schistosomiasis in prioritized areas has been going on
since the year 2012. By the year 2013 over 6 million School Age Children (SAC) had
been treated. A community sensitization supplement containing key messages and
answers to frequently asked questions was developed as a guiding tool. Awareness
creation methods used include county sensitization meetings, stakeholder forums, town
criers and posters. To assess the local stakeholders' perceptions of community
sensitization for programme implementation, a qualitative cross-sectional survey was
conducted in four-sub-counties of coastal region.
Methods: In-depth interviews (IDIs) were administered to 40 purposively selected
opinion leaders so as to explore their perceptions of awareness creation sources,
adequacy of information given, length of period of awareness creation and period
between which information is given and drugs are administered. Separate IDIs were
administered to pre-school teachers (41), community health extension workers (34) and
primary school teachers (38). To elicit more information, 20 focus group discussions
(FGDs) categorized by gender and age were conducted among parents of school-age
children. Data was audio recorded, transcribed, coded and analyzed manually by study
themes.
Results: The most commonly reported source of information was school pupils. Due to
low literacy levels, use of posters was regarded as ineffective and religious institutions,
town criers and vernacular radio stations considered more effective. The information
given during programme implementation was considered inadequate and use of
complementary methods to reach all targeted children including the non-enrolled, and
relay adequate information reported as important. Use of school and chief's meetings
with health personnel being present was mentioned as a useful method that would allow
for interaction with participants indicating that they did not understand why adults were
not being treated. Repeated awareness creation before deworming day to serve as a
reminder and to reach those missing initial messages was also mentioned as important.
Furthermore, the awareness creation period needed to be extended as 85% of the
participants indicated that they learnt of deworming a day before it took place or after
their children had received the drugs.
Conclusion: Awareness creation is a key factor in the success of NSBDP
implementation. For programme sustainability, preferences of local stakeholders need to
be considered as control of worms can only be achieved through an integrated approach
of deworming, health education and use of safe water and sanitation facilities which
require collaboration with local stakeholders.