Purpose
Despite the implementation of ongoing mass drug administration (MDA) campaigns, South Sudan remains endemic for six Preventive Chemotherapy Neglected Tropical Diseases (PC-NTDs); this persistent endemicity is attributed to complex sociocultural barriers and healthcare delivery challenges. Integrating gender equity and social inclusion (GESI) is essential to identify barriers to equitable MDA delivery and develop targeted, inclusive solutions.
Methods
This study includes a assessment of barriers among adults who did not receive MDA during the most recent campaign, which employed WI-HER’s iDARE methodological framework, integrating root cause analysis and qualitative interviews with a total of 256 participants in Awerial County. The study explored factors such as gender roles, cultural norms, and access disparities that affect MDA participation among marginalized populations including nomadic pastoralists, women, internally displaced persons, and persons with disabilities.
Results
Findings revealed persistent barriers including geographical challenges, limited awareness, mobility constraints, and sociocultural norms that differentially impact population groups. Gender-specific risk factors were identified, with men exposed through cattle farming and hunting activities, while women faced risks through domestic responsibilities like water collection. Although most respondents (70.4%) perceived equal healthcare access, notable disparities were found in MDA participation, particularly among mobile populations.
Conclusion
The study underscores the importance of integrating GESI principles into NTD programming to enhance equitable participation of everyone at risk of the disease and address inequities in access to interventions. Recommendations include gender-responsive strategies, community-driven engagement, and targeted training for MDA implementers. Embedding GESI into NTD programming is essential for equitable MDA coverage and sustainable elimination in post-conflict settings.