Achieving equity in UHC interventions: who is left behind by neglected tropical disease programmes in Cameroon?

Figures & data

Figure 1. Excerpt from Cameroon map showing 5 health districts used for study

Table 1. Participant information showing different levels, characteristics and geographic location of different stakeholders

Level of Intervention	Stakeholders Met	Interviews			Gender		Total Number of stakeholders met	Sites
		Individual interview	FDG	Local level meeting	Male	Female
Community	Community members (parents included)	57	3	0	40	58	98	Edea, Barombi Mbo, Barombi Kotto, Malanteoun
	Teachers	18	2	1	18	30	48
	Community drug distributors	7	2	0	20	7	27
	Health workers	12	0	0	5	7	12
	Council workers/officials	4	1	0	10	4	14
Intermediary	Health officials	5	0	0	3	2	5	Edea, Barombi Mbo, Barombi Kotto, Malanteoun
	Council workers/officials	6	0	0	4	2	6
Strategic	Implementing partners	9	0	0	8	1	9	Yaoundé

Figure 2. Summary of coding process adapted from Vaismoradi et al 2013 [28]

Figure 3. Missed populations during mass drug administration in Cameroon

Table 2. Results table to show clear problem-solution linkages and commonality across results

Who is missed	Why are they missed	Who can help	How can they help
Farming communities	Absence during distribution Insufficient sensitization (time and content) Distribution period	National Program implementation (National Programs for the specific NTDs)	By adapting programs to community calendars. By upgrading sensitization efforts through increased time and more informative sensitization (side effects, reasons for medicines, why needed, effects of not taking, methods of contamination and transmission)
Migrant populations	Absence of migrant communities during distribution Context/cultural differences leaving populations left out in sensitization and distribution	National Program implementation Quarter heads/village leaders identified in different communities	Programs should engage and train community leaders so they may identify people currently left out and conduct sensitization and distribution to facilitate understanding and acceptance of why medicines are needed. Ensure better understanding migrant patterns of workers
Young girls and women of reproductive age	Pregnant and lactating mothers not offered Fear and mistrust due to insufficient sensitization Training of CDDs in relation to this group of women Include or revisit national Policy on treating women and young girls	National Policy/Program implementation	Policy specifications on the distribution of drugs to pregnant women by drug distributors should be updated and implemented consistently according to the World Health Organization recommendation Information on administering medicines to pregnant women shared with health districts and included in the training on CDDs (distribution of praziquantel for Schistosomiasis control specifically). Content of sensitization messages should include information on safety, including the need for medicines and addressing side effects, to dispel fears around impacts on pregnancy and fertility of young girls.
Children	Out school of children not met Private (and least populated) schools mostly left out	National Program policy National Program planning. Education Sector partners. Health Sector partners	Include clear plan for distribution of medicines to out of school children during school-based distribution, or if already existing, practiced and monitored for effectiveness. Program planning and implementation to identify mechanisms to reach private schools being left out

Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013;15:398–405.

 PubMed Web of Science ®Google Scholar