1*PhD Scholar, School of Health Sciences, Om Sterling Global University, Hisar, Haryana, India.
2Professor & Supervisor, School of Health Sciences, Om Sterling Global University, Hisar, Haryana, India.
3Associate Professor & Co-supervisor, School of Health and Allied Sciences, Pokhara University, Nepal
4Director, Clinical Diagnostic and Research Centre (CDRC), Nita PathLabs, Kathmandu, Nepal
5CEO, Suvekchya International Hospital, Kathmandu, Nepal
Background: Lymphatic filariasis (LF), a disabling neglected tropical disease, persists in Nepal despite mass drug administration (MDA) efforts targeting 2030 elimination. Health workers (HWs) drive MDA success through planning, delivery, and community engagement, yet their knowledge, attitudes, and roles remain underexplored.
Methods: This mixed-methods study assessed HWs' contributions in three endemic districts (Sarlahi, Rautahat, Rasuwa). Exploratory sequential design began with three focus group discussions (FGDs; n=25 HWs) using purposive sampling until thematic saturation, analyzed via Braun & Clarke thematic analysis. This informed a cross-sectional survey of 257 HWs selected via multi-stage sampling (districts, municipalities, population-proportionate).
Results: Logistic regression identified predictors of knowledge (16 items; optimal=42.8%), attitudes (11 Likert items; favorable=45.1%), and engagement (composite; optimal=63.8%). Non-Hindu HWs (AOR=2.69, 95% CI 1.04–6.9) and urban workers (AOR=2.11, 95% CI 1.11–4.00) had superior knowledge; younger HWs showed better attitudes. Qualitative themes positioned HWs as strategic implementers, community mediators, compliance facilitators, teamwork enablers, and program optimizers—roles challenged by training gaps, logistics, and rumors. Mixed-methods integration revealed overburdened high-engagers with suboptimal attitudes.
Conclusion: Findings underscore HWs' pivotal, multifaceted roles and the need for targeted training, incentives, and supervision to bolster Nepal's LF elimination. This evidence supports GPELF strategies in resource-limited settings.
Keywords: Lymphatic filariasis, mass drug administration, health workers, knowledge-attitude-engagement, Nepal, mixed-methods
How to cite this article: Ojha AB, Hasan N, Paneru DP, Raman RK, Adhikari HP. Role of Health Workers in the Management of Mass Drug Administration in Lymphatic Filariasis Elimination Program of Nepal: A Mixed-Methods Study. Int J Drug Deliv Technol. 2026;16(10s): 340-344; DOI: 10.25258/ijddt.16.10s.46.
Source of support: Nil.
Conflict of interest: None