Factors Associated With the Motivation of Community Drug Distributors in the Lymphatic Filariasis Elimination Programme in Kenya

ABSTRACT

Annual mass drug administration (MDA) is the main strategy for elimination of lymphatic filariasis (LF); globally. In Kenya; community drug distributors (CDDs) are used to deliver drugs to household members. To determine factors influencing CDDs' motivation; a retrospective cross-sectional study based on qualitative data was conducted in Kwale and Malindi districts after the 2008 MDA. In Kwale; Tsimba location represented high and Gadini low compliance while in Malindi; Goshi and Gongoni locations represented high and low compliance areas; respectively. Fifteen CDDs; 80 opinion leaders; 80 LF patients; five health personnel; four LF coordinators and the National Programme Manager were purposively selected and interviewed. Sixteen focus group discussions (FGDs) were conducted with single-sex adult and youth male and female groups. The factors that possibly had a positive influence on CDDs' motivation were higher education level; trust and familiarity with community members. All CDDs reported that getting recognised; being trained on LF and an innate desire to help their communities raised their motivation. Factors that possibly had negative influence included inadequate training; drug supplies and community sensitisation and lack of supervision. The majority of the CDDs reported a lack of or outdated record-keeping books; a limited drug distribution period; inadequate moral support and incentives as negative factors on their motivation. Factors that motivate CDDs are those that enhance their capacities to perform their duties and endear respect in the communities where they serve