Table 2.
Summary of identified facilitators and barriers
| Structural or broad themes | Emergent themes (number of studies) | |
|---|---|---|
| Facilitators | Barriers | |
| Social mobilization/Community engagement/(Health education). | Awareness creation through community led health education programmes (n = 3) [36, 37, 42]. | Limited investment in appropriate timing, dissemination of accurate MDA for LF information (n = 3) [21, 38, 44]. |
| Innovative and locally relevant means to conduct health education/modern and traditional approaches to H.E. (n = 4) [22, 36, 37, 39]. | ||
| Use of appropriate IEC materials for health education (n = 5) [22, 24, 36, 37, 42]. | ||
| Involve key health systems representatives and local leaders in health education (n = 7) [22, 23, 25, 34, 36, 37, 41] | ||
| Community drug distributors in MDA for LF implementation. | Selection, training and financial incentives provided to CDDs (n = 5) [22, 25, 34, 35, 37, 44], and provision of mobile phones and other forms of motivation (n = 1) [45]. | Limited number of CDDs to implement MDA for LF (n = 4) [22, 23, 25, 35]. |
| Allocation of large number of household areas to CDDs for drug distribution (n = 4) [21, 35, 38, 44]. | ||
| Political and health systems factors in MDA for LF implementation. | Building of partnerships and collaborations (international and local), resulting in sustained political commitment to MDA for LF (n = 7) [22, 23, 36, 37, 40, 42, 43]. | Major disease outbreaks may paralyze health systems and affect MDA for LF (n = 2) [33, 44] |
| Integration with existing health interventions (n = 4) [36, 37, 39, 42] | ||
| Innovative resource mobilization strategies in environments totally lacking local resources (n = 1) [36] | ||
| Establishment of morbidity management programmes (n = 3) [39, 40, 43] | ||
| Adverse effects management during MDA for LF implementation (n = 6) [34, 36, 37, 39–41]. | ||
| Population dynamics affecting MDA for LF Implementation. | Lack of clear geographical demarcations in MDA for LF implementation units (n = 2) [22, 23] | |
| Rapid urbanization and employment seeking population migrations into MDA for LF implementation units (n = 2) [22, 23] | ||
| MDA for LF drug commodities and logistics supply. | Late delivery and procurement of MDA for LF drugs at community and international level (n = 3) [23, 36, 37]. | |
| Unsustainable and inappropriate drug delivery strategies for given settings (n = 4) [21, 23, 36, 37]. | ||