03329nas a2200349   4500000000100000008004100001260003700042653004100079653001300120653002100133653001300154653001300167653003000180100002400210700001400234700002300248700002100271700002400292700001400316700002400330700002200354700001200376700002000388700002000408700001600428245017300444856009800617300000900715490000700724520223400731022001402965       2024                            d  bPublic Library of Science (PLoS)10amass drugs administration strategies10aTrachoma10aGeohelminthiasis10aColombia10aAmazonas10aBarriers and facilitators1 aTrujillo-Trujillo J1 aZamora SM1 aBernal Lizarazu MC1 aTorres Pérez ML1 aBellido Cuéllar OE1 aAraque CV1 aPulido Martínez SJ1 aVargas Peláez CM1 aRossi F1 aMoyano Ariza LF1 aBernal Parra LM1 ade Souza DK00aAccess barriers and facilitators to implement mass drugs administration strategies for eliminating trachoma and geohelminthiasis in the department of Amazonas, Colombia  uhttps://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0310143&type=printable  a1-230 v193 a<p><strong>Background:</strong> One of the most important pillars of action to achieve the elimination of trachoma and soil-transmitted helminth infections as a public health problem is the mass administration, at regular intervals, of azithromycin and anthielmintics, respectively, to a high proportion of the eligible population in endemic areas.</p>

<p><strong>Objective:</strong> The objective of the study was to identify access barriers and facilitators for achieving coverage goals in the mass drugs administration, azithromycin and albendazole, in the department of Amazonas, Colombia.</p>

<p><strong>Methodology: </strong>Implementation research was used, combining three types of qualitative research methodologies to collect information about access barriers and facilitators already described; These were individual and group interviews, focus group discussions and face-to-face intercultural dialogues. We design, validate and apply different instruments with questions adapted to the context and role of the participants, and recorded and transcribed the sessions and analyzed them in qualitative analysis software. We used the Consolidated Framework for Implementation Research (CFIR) to complement the above instrument questions, to guide data analysis, and apply the Consolidated Criteria for Reporting Qualitative Research (COREQ).</p>

<p><strong>Results: </strong>Records of 159 participants were included; 21 individual and 3 group interviews, 6 focus group discussions and 4 intercultural dialogues were carried out. 21 strong, 30 weak, 6 neutral barriers as well as 5 weak and 11 strong facilitators were identified. 62% of the strong barriers and 40% of the weak ones were concentrated in the “Outer Setting Domain”. Only 16 facilitators were identified, 44% in the “Innovation” domain.</p>

<p><strong>Conclusions:</strong> Multiple political, administrative, geographical, logistical and cultural access barriers, as well as external and internal migration of the population, explain low coverage in mass administration of azithromycin and albendazole. It is necessary to review them individually to implement an improvement plan that also recognizes the identified facilitators.</p>
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