By Caroline Kusi
Dr. Bill Foege – who co-founded The Task Force for Global Health, among his many other contributions to public health – once said, “if we are to maintain the reputation this institution now enjoys, it will be because in everything we do, behind everything we say, as the basis for every program decision we make − we will be willing to see the faces.”
For those of us who work to eliminate neglected tropical diseases (NTDs), seeing the faces means recognizing the importance of the social-cultural, political, and economic contexts in which the people we serve live, and meeting them where they are. Seeing the faces means that we, as researchers and global health practitioners, must address barriers to treatment and ensure that at-risk groups realize their right to good health. Seeing the faces means taking the time to understand who is being missed and why. And this is where social science research comes in.
While some public health sectors such as childhood immunizations and HIV/AIDS have utilized social science to accelerate meeting their goals, it has played a limited role until recently in research on NTDs.
Now, with the support of UK aid from the British government, The Task Force’s Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD) is working to bridge that gap. We issued a call for proposals at the most recent COR-NTD meeting in Baltimore, MD, on equity in mass drug treatments. The call challenged researchers and NTD programs to think about the groups that are being left behind, and utilize social science methods to effectively engage drug distributors, frontline healthcare workers, and at-risk groups.
For instance, in Uganda and the Ivory Coast, researchers used social science research to develop and deploy additional tools and training modules to address the needs of community drug distributors, a pivotal link between the country’s NTD program and the people affected by the disease. One of the tools involved providing timely feedback to drug distributors about progress toward treatment goals so they could improve or adjust coverage accordingly.
Social science research can be effective and its findings meaningful because it empowers communities and promotes their strong involvement in everything from identification of research questions, to data interpretation, to leadership in the development and implementation of interventions. This process ensures that there is sufficient community “buy-in” and ownership, which are key ingredients for effective and sustainable interventions.
We must also strengthen the linkages and collaborations among local academic institutions, implementing partner organizations, and national NTD programs. By fostering these collaborations, we can ensure that context-specific strategies are evidence-based and relevant to programs. Progress will not be made if partners work in silos.
While reviewing entries following the COR-NTD call for proposals, we looked for evidence of engagement between researchers and implementers, and an emphasis on country capacity building. The three studies selected are all led by local researchers and demonstrate engagement with country programs, as well as utilization of rigorous social science methods and frameworks to address barriers to the successful planning and implementation of mass drug administration (MDA).
In Indonesia, Pattimura University will be working with the Department of Health to develop field-applicable tools for enhanced and targeted social mobilization strategies. In Coastal Kenya, researchers at the Kenya Medical Research Institute will be working closely with the national NTD program to address the different challenges experienced by urban and rural MDA. Finally, in Tanzania and Kenya, the Kilimanjaro Centre for Community Ophthalmology will work with both Ministries of Health to address challenges of reaching nomadic populations during MDA.
This exciting pivot towards a more country-led and participatory approach will be critical to achieving elimination targets for NTDs. I, for one, am very excited to see where it can take us.
Caroline Kusi is a Senior Program Associate at The Task Force’s Neglected Tropical Disease Support Center (NTD-SC) where she serves as the research lead for the center’s social science research portfolio.