02299nas a2200265 4500000000100000008004100001260003400042653005700076653002100133653002800154653002900182653003600211100001100247700001300258700001500271700001500286700001200301700001100313700001300324700001500337245020600352856011000558520134000668022002502008 2023 d bOxford University Press (OUP)10aPublic Health, Environmental and Occupational Health10aGeneral Medicine10aHealth (social science)10aMass drug administration10aUniversal health coverage (UHC)1 aTate A1 aKollie K1 aSenyonjo L1 aSturrock H1 aDowns P1 aBush S1 aBedell A1 aMolyneux D00aIs the neglected tropical disease mass drug administration campaign approach an effective strategy to deliver universal health coverage? A case study of the Liberia neglected tropical disease programme uhttps://academic.oup.com/inthealth/advance-article-pdf/doi/10.1093/inthealth/ihad035/50339980/ihad035.pdf3 a

Background
Access to affordable, quality healthcare is the key element of universal health coverage (UHC). This study examines the effectiveness of the neglected tropical disease (NTD) mass drug administration (MDA) campaign approach as a means to deliver UHC, using the example of the Liberia national programme.

Methods
We first mapped the location of 3195 communities from the 2019 national MDA treatment data reporting record of Liberia. The association between coverage for onchocerciasis and lymphatic filariasis treatment achieved in these communities was then explored using a binomial geo-additive model. This model employed three key determinants for community ‘remoteness’: population density and the modelled travel time of communities to their supporting health facility and to their nearest major settlement.

Results
Maps produced highlight a small number of clusters of low treatment coverage in Liberia. Statistical analysis suggests there is a complex relationship between treatment coverage and geographic location.

Conclusions
We accept the MDA campaign approach is a valid mechanism to reach geographically marginal communities and, as such, has the potential to deliver UHC. We recognise there are specific limitations requiring further study.

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