03176nas a2200313   4500000000100000008004100001260003700042653002400079653005700103653003900160100001300199700001600212700001500228700001400243700002200257700002200279700002500301700002000326700001300346700001200359700001300371700001600384245017100400856009900571300001300670490000700683520215800690022001402848       2023                            d  bPublic Library of Science (PLoS)10aInfectious Diseases10aPublic Health, Environmental and Occupational Health10aCommunity drug distributors (CDDs)1 aArney JK1 aHeadland MK1 aBertone AM1 aMéité A1 aEttiegne-Traore V1 aAsemanyi-Mensah K1 aDede Teiko Dzathor I1 aKargbo-Labour I1 aJalloh U1 aHouck P1 aStukel D1 aPhillips RO00aSynthesis of findings from the literature and a qualitative research study on the impacts of gender, disability, and ethnicity in Neglected Tropical Diseases programs  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011782&type=printable  ae00117820 v173 a<p>Introduction Act to End NTDs | West, a USAID-funded program that supports national governments to eliminate or control five neglected tropical diseases (NTDs) in West Africa including trachoma, lymphatic filariasis (LF), onchocerciasis, schistosomiasis and soil-transmitted helminthiasis, conducted a gender and social inclusion analysis to determine how NTDs differentially impact various populations and how gender and social norms impact NTD programs to inform future programming.</p>

<p>Methods The study used a mixed methods approach including a literature review; primary qualitative data collection; and monitoring data in Côte d’Ivoire, Sierra Leone, and Ghana. Results Women and girls face additional health risks from many NTDs compared to men and boys. In addition to differential health burden, the social and economic impacts of NTD-related disability or infertility can be particularly dire for women and girls. Men were somewhat less likely to participate in mass drug administration (MDAs) due to: lack of information about campaigns, lack of access due to work, and higher levels of mistrust of the government and concerns about side effects of the medicines. Pregnant and breastfeeding women were sometimes excluded by community drug distributors (CDDs) from certain types of MDAs for which they are eligible. Training participation rates for CDDs and supervisors were universally higher for men than women, even though feedback on the effectiveness of female CDDs was overwhelmingly positive, and female CDDs often have more access to other women in conservative households. The role of a CDD can lead to career and social opportunities for women. However, challenges faced by CDDs were seen as a greater barrier for women, including transportation, safety, household responsibilities, lower education levels, and low or lack of wages. Discussion Programs to address NTDs can promote equity and improve programming by increasing women’s participation as CDDs and providing financial compensation. Additionally, programs should prioritize inclusive training for CDDs, and inclusive messaging about MDA for communities.</p>
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