Seeing the Faces: Why Social Science is Important in the Fight Against Neglected Tropical Diseases

A mother gives antibiotic medication to her child in Lackson Village, Chikwawa District, Malawi. (Photo by Billy Weeks)

Bill Foege — who founded The Task Force for Global Health, among his many other contributions to global 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.”

Seeing the faces means recognizing the importance of the social-cultural, political, and economic context 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 the barriers to acceptability, accessibility, and availability of treatment; and ensure that at-risk groups realize their right to health. Seeing the faces means taking the time to understand who is being missed and why.

Until recently, social science played a limited role in research on neglected tropical diseases, or NTDs; however, this has not been the case across all sectors in global health: Childhood immunizations, malaria, HIV/AIDS, and water, sanitation, and hygiene (WASH) programs, among others, have used social science to help accelerate their goals.

A young boy takes antibiotic medication In Chimphepo Village, Chikwawa District, Malawi (Photo By Billy Weeks)

Now, with the support of UK aid from the British government, the Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD) is working to bridge that gap. Together, we issued a call for proposals at the most recent COR-NTD meeting in Baltimore, Maryland, on equity in mass drug administration (MDA). The call challenged researchers and NTD programs to think about the groups that are being left behind and utilize social science methods and frameworks to effectively engage drug distributors, frontline healthcare workers, and at-risk groups.

Community-based, participatory operational research is key to achieving this goal. This research model 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 between 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.

Families gather for antibiotic medication that was distributed In Timbenao Village, Chikwawa District, Malawi (Photo By Billy Weeks)

As such, evidence of engagement between researchers and implementers and emphasis on country capacity building were key criteria during our review of proposals submitted in response to the recent call for proposals. 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 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 of 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.

About the Author

Caroline Kusi is a Senior Program Associate for the Neglected Tropical Disease Support Center (NTD-SC) where she serves as the research lead for the center’s social science research portfolio. With major grants from the Bill & Melinda Gates Foundation, USAID, and UK aid from the British people, NTD-SC is Secretariat for the Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD).

Photo Credit: Billy Weeks for The Task Force for Global Health