Project coordination
Kenya Medical Research Institute (KEMRI)

Partners
Ifakara Health Institute
Ministry of Health, Kenya
Ministry of Health, Tanzania

Aim: The study aims to develop feasible and sustainable community advocacy, communication, and social mobilization (ACSM) interventions to inform the design of implementation research and enhance integrated Morbidity Management and Disability Prevention (MMDP) for the prevention, control, and eventual elimination of leprosy, lymphatic filariasis, and tungiasis, particularly in Kenya and Tanzania.

Full project title:
An implementation research to develop integrated interventions for community mobilization and advocacy for control and elimination of Leprosy, LF and Tungiasis in Kenya and Tanzania.

Leprosy, LF, and Tungiasis are neglected tropical diseases (NTDs) that still affect marginalized communities in Kenya and Tanzania, causing physical, social, and economic harm. While treatment programs exist through multi-drug therapy (MDT) for Leprosy, with Kenya and Tanzania reaching post MDA surveillance phases for LF, uptake and coverage remain inconsistent in some endemic communities. In the recent past, there has been reported resurgence and reemergence of new cases in the Kenya and Tanzania calling for interventions to address the i) socio-economic factors such as poverty, poor water, sanitation and hygiene practices(WASH), inadequate housing, overcrowded living conditions, low literacy and disease awareness, stigma and discrimination, ii) environmental factors, and iii) health system determinants; limited access to care, costs of access, delayed diagnosis and treatment, inadequate infrastructure and specialized personnel, and insufficient resources, key contributors to transmission and disease incidence.

The goal of this study is to use integrated advocacy, communication and social mobilization (ACSM) strategies to raise awareness, improve disease perception, reduce stigma, promote prevention, and early seeking of care. By combining ACSM efforts with innovations such as Morbidity Management and Disability Prevention (MMDP), decentralization of care through introduction of skin clinics at local health facilities and health messaging, the project aims to strengthen the fight against these diseases in the affected communities.

This is a mixed methods study conducted in Kenya and Tanzania with a formative , intervention and post-intervention approach. Quantitative data will be collected through a survey with 854 community members to assess drivers of infection, community knowledge and perceptions towards leprosy, LF and tungiasis. Culturally acceptable ACSM materials will be developed and rolled out to the study communities and an endline survey conducted to assess the impact of ACSM.

Qualitative data will be collected through micro narratives with persons with disabilities from the three skin diseases to assess their lived experiences, required social economic support, stigma reduction strategies and barriers and facilitators of uptake of MMDP, households of randomized patients into the MMDP interventions will be GPS mapped for ease of follow-up. Focus group discussions (FGDs) with community members and in-depth interviews with community leaders to help the team establish baseline data on social and health determinants will be conducted. To understand health system drivers of infections and intervention sustainability, key informants interviews (KIIs) will be conducted with healthcare workers, NTD program managers and policymakers. Costing of community driven outreach skin clinics will be conducted to assess feasibility.

Quantitative data will be analyzed using STATA version 15 while qualitative data will be analyzed using NVivo version 12.0. The study is expected to generate a novel scientific innovation by providing the first evidence on the integration of ACSM and MMDP for skin-related NTDs. It will produce practical tools, including ready-to-use training manuals, costing templates, and validated stigma measurement scales. For policy impact, the study will develop a blueprint to inform the Kenya and Tanzania NTD master plans, as well as contribute to the refinement of WHO guidelines.