{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:13:21Z","timestamp":1790363601428,"version":"4.1.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0008857","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T00:00:00Z","timestamp":1607472000000}}],"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T00:00:00Z","timestamp":1606262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Foreign, Commonwealth and Development Office","award":["Grant ID \u2013 PO 6407"],"award-info":[{"award-number":["Grant ID \u2013 PO 6407"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Nigeria has the highest burden of NTDs in sub-Saharan Africa. Commitments to reach the control and elimination of many Neglected Tropical Diseases (NTDs), particularly those amenable to preventive chemotherapy (onchocerciasis, schistosomiasis, soil transmitted helminths, lymphatic filariasis and trachoma) by 2020 are detailed in the London declaration. Strategies to reach targets build on existing approaches, one of which is the use of community directed intervention (CDI) methods to deliver the mass administration of medicines (MAM). However, treatment using this approach has been inconsistent and there are questions about the acceptability and adaptability of these interventions during periods of programmatic, social, and political change. This paper explores the current strengths and weaknesses of CDI approaches in MAM delivery. We consider the acceptability and adaptability of existing MAM approaches to ensure equity in access to essential treatments. Using qualitative methods, we explore implementer perspectives of MAM delivery. We purposively selected programme implementers to ensure good programmatic knowledge and representation from the different levels of health governance in Nigeria. Data collection took place across two States (Kaduna and Ogun). Our results indicate that CDI approaches have underpinned many historic successes in NTD programme acceptance in Nigeria, specifically in Kaduna and Ogun State. However, our results also show that in some contexts, factors that underpin the success of CDI have become disrupted presenting new challenges for programme implementers. Capturing the tacit knowledge of health implementers at varying levels of the health system, we present the current and changing context of MAM delivery in Kaduna and Ogun States and consolidate a platform of evidence to guide future programme delivery and research studies. We situate our findings within the broader NTD literature, specifically, in identifying how our findings align to existing reviews focused on factors that shape individual acceptance of MAM.<\/jats:p>","DOI":"10.1371\/journal.pntd.0008857","type":"journal-article","created":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T18:37:49Z","timestamp":1606329469000},"page":"e0008857","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":20,"title":["Mass administration of medicines in changing contexts: Acceptability, adaptability and community directed approaches in Kaduna and Ogun States, Nigeria"],"prefix":"10.1371","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0347-3770","authenticated-orcid":true,"given":"Oluwatosin","family":"Adekeye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Ozano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Dixon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6988-7194","authenticated-orcid":true,"given":"Elisabeth Osim","family":"Elhassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luret","family":"Lar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunday","family":"Isiyaku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7496-4118","authenticated-orcid":true,"given":"Okefu","family":"Okoko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Thomson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Theobald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Dean","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,11,25]]},"reference":[{"issue":"10","key":"pntd.0008857.ref001","doi-asserted-by":"crossref","first-page":"e0004744","DOI":"10.1371\/journal.pntd.0004744","article-title":"Blue Marble Health and the Global Burden of Disease Study 2013","volume":"10","author":"PJ Hotez","year":"2016","journal-title":"PLoS neglected tropical diseases"},{"issue":"10","key":"pntd.0008857.ref002","doi-asserted-by":"crossref","first-page":"e0005085","DOI":"10.1371\/journal.pntd.0005085","article-title":"Integrated Healthcare Delivery: A Qualitative Research Approach to Identifying and Harmonizing Perspectives of Integrated Neglected Tropical Disease Programs","volume":"10","author":"AR Means","year":"2016","journal-title":"PLOS Neglected Tropical Diseases"},{"issue":"4","key":"pntd.0008857.ref003","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/inthealth\/ihw031","article-title":"Tailoring mass drug administration to context: implementation research is critical in achieving equitable progress in the control and elimination of helminth neglected tropical diseases in sub-Saharan Africa","volume":"8","author":"L Dean","year":"2016","journal-title":"International Health"},{"issue":"1623","key":"pntd.0008857.ref004","article-title":"Preventive chemotherapy as a strategy for elimination of neglected tropical parasitic diseases: endgame challenges","volume":"368","author":"MJ Bockarie","journal-title":"Philosophical transactions of the Royal Society of London Series B, Biological sciences"},{"key":"pntd.0008857.ref005","unstructured":"World Health Organization. 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