Comparing cost to participate as community drug distributor (CDD) in mass drug administration for preventive chemotherapy of onchocerciasis and lymphatic filariasis in an urban and a rural district in Côte d’Ivoire Público
Hassan, Adolfo (Spring 2023)
Published
Abstract
Mass drug administration (MDA) programs are essential in combating neglected tropical diseases (NTDs) in low-resource settings. Community drug distributors (CDDs) play a critical role in the successful implementation of MDA programs. This study aims to investigate the opportunity costs faced by CDDs in urban and rural districts of Côte d'Ivoire and assess the relationship between these costs and the duration of volunteer service (retention) in the program. Data was collected through a survey of CDDs in an urban (n=76) and a rural (n=60) district, capturing demographics, education, occupation, hours spent on MDA activities, out-of-pocket expenditures, and monetary incentives. The opportunity cost was derived as the net cost to participate, using both self-reported income and minimum wage data. Welch Two Sample t-tests were performed to assess the differences in net costs between urban and rural CDDs, and an ordinal logistic regression model was fitted to examine the relationship between the duration of volunteer service and net cost. The results show significant differences in net costs between urban and rural CDDs using both self-reported income (p-value < 0.001) and minimum wage data (p-value = 0.002). Urban CDDs faced higher net costs, indicating a greater opportunity cost to participate in MDA programs. The ordinal logistic regression model revealed a significant negative relationship between net cost and duration of volunteer service (p-value < 0.001), suggesting that higher net costs are associated with decreased odds of CDDs staying in the program for a longer duration. These findings highlight the importance of understanding the opportunity costs faced by CDDs and their impact on retention in MDA programs. Policymakers and program implementers should consider measures to minimize opportunity costs, such as providing adequate compensation and support, to enhance CDD retention and ensure the success of MDA programs in controlling and eliminating NTDs.
Table of Contents
Table of Contents
Chapter 1: Introduction.........................................................................................1
1.1 Overview.........................................................................................................1
1.2 Purpose Statement.........................................................................................2
1.3 Hypotheses.....................................................................................................2
1.4 Significance....................................................................................................3
Chapter 2: Literature Review.................................................................................4
2.1 Lymphatic Filariasis.......................................................................................4
2.2 Urban Lymphatic Filariasis............................................................................5
2.3 Onchocerciasis...............................................................................................6
2.4 Urban Onchocerciasis....................................................................................8
2.5 Community Drug Distributors.......................................................................8
Chapter 3: Methodology.......................................................................................13
3.1 Introduction..................................................................................................13
3.2 Population.....................................................................................................13
3.3 Research Design............................................................................................14
3.4 Procedures.....................................................................................................14
3.5 Ethical Considerations...................................................................................17
3.6 Limitations.....................................................................................................18
Chapter 4: Results.................................................................................................19
4.1 Demographics................................................................................................19
4.2 Distribution of Time Spent as a Community Drug Distributor.....................20
4.3 Out-of-pocket Expenditures and Monetary Incentives.................................21
4.4 CDDs Opportunity Cost................................................................................. 22
4.5 Ordinal Logistic Regression Model............................................................... 23
Chapter 5: Discussion........................................................................................... 25
5.1 Implications...................................................................................................26
References.............................................................................................................28
Appendix...............................................................................................................32
About this Master's Thesis
| School | |
|---|---|
| Department | |
| Degree | |
| Submission | |
| Language |
|
| Research Field | |
| Palabra Clave | |
| Committee Chair / Thesis Advisor |
Primary PDF
| Thumbnail | Title | Date Uploaded | Actions |
|---|---|---|---|
|
|
Comparing cost to participate as community drug distributor (CDD) in mass drug administration for preventive chemotherapy of onchocerciasis and lymphatic filariasis in an urban and a rural district in Côte d’Ivoire () | 2023-04-20 13:25:11 -0400 |
|
Supplemental Files
| Thumbnail | Title | Date Uploaded | Actions |
|---|