Community health workers walk from house to house in this rural community, distributing medicine as part of the expanded populations MDA in Bungoma, Kenya.
Expanding Treatments to
Reach Everyone at Risk
Beatrice Mugata watched each year as her three grandchildren, whom she cares for, received deworming medication in school. She lives in Bungoma County, a district just north of Lake Victoria in Kenya. This county has been targeted for annual, school-based deworming campaigns for years. She noticed her grandchildren’s energy levels improved, and they were able to help her more with chores around the house. But, she wondered, if they all lived in the same area, ate the same food, drank the same water, why wasn’t she also getting this medicine to kill the parasites living in her area?
“Our approach was quite different, we didn’t just focus on schools, we also focused on households, fixed points like churches and markets… It was targeting everyone compared to our normal deworming where we usually only target (children) around 2-14 (years old).”
Awino Cynthia – a public health officer in western Kenya.
Historically, programs to control intestinal worms and schistosomiasis have focused on treating children due to the significant burden in this age group. This is compounded by worms stealing nutrients at a time when children are still growing, so the effect on their development can be devastating. However, if only children are treated, they will go home to an environment where the worms are still present and will continue to be infected. Only by treating everyone at risk can the transmission of the parasites be interrupted, which is a necessary step in ending these diseases.
Kenya’s Breaking Transmission Strategy for NTDs aims to interrupt the transmission of the four most common NTDs through the combined strategies of expanded mass drug administration (MDA), water, sanitation, and hygiene interventions, and behavior change communications. The Deworming Innovation Fund (DIF) works with its partners in Kenya to support the Breaking Transmission Strategy to accelerate the interruption of transmission of intestinal worms and schistosomiasis.
In order to provide deworming treatment to everyone at risk, community health workers need to canvas the area, going door to door to explain to each family why they should take the free medicine. In Bungoma, the community health workers try to visit each household once a month to check on the general health of the families. This type of continuous care has made them trusted sources of information in their communities, so they usually have no problem convincing people to take the medicine. For Beatrice, it was an easy decision, and after she received the medicine, she noticed that her appetite improved and her energy levels increased.
Achieving progress is a collaborative effort, and alongside the invaluable work of community health workers, local governments are essential to the sustainability of DIF. The END Fund has supported successful advocacy to government officials for increased prioritization of NTDs across all four counties in Kenya participating in DIF (Kakamega, Vihiga, Bungoma, and Trans Nzoia). As a result, we have seen NTDs included for the first time in each county government’s five-year integrated development plan, which guides local government spending.