“We Are Just Supposed to Be an NGO Helping”: A Qualitative Case Study of Health Workers’ and Volunteers’ Perceptions of the Government and Civil Society’s Role in Fighting Jiggers in Bungoma County, Kenya

Non-governmental organizations (national and international) are important actors in addressing health issues in Kenya. Sandflea/jigger infections (tungiasis) are a public health challenge that severely affect children, older adults, and other vulnerable people in poor communities worldwide. In Kenya, NGOs have been involved in sandflea eradication for more than twenty years. Without treatment, the flea may cause debilitating infections and sores, resulting in difficulties with walking and grasping, as well as social harassment. This paper aims to shed light on health workers’ and volunteers’ perceptions of the government and civil society’s role in fighting jigger infections. Data were collected through a qualitative case study design, with a three-month fieldwork including participation in mobile jigger removal programs, 18 semi-structured in-depth interviews, informal talks, and observations, in five villages in Bungoma County. The thematic analysis of the data resulted in three recurring themes: (1) the NGO-driven jigger program as a (fragile) resource for local communities, (2) the need for more consistent collaboration between NGOs and public health services, and (3) the local perceptions of the governments’ responsibilities in combatting the plague. The findings imply that the 10-year-old national policy guidelines on the prevention and control of jigger infestations need to be updated; this includes the coordination of the public and private actors’ roles, the incorporation of lessons learned, and the need for a multisectoral One Health approach to combat the jigger menace in the country.