Table 1 Concerns voiced by Ministry of Health and Implementing Partners regarding the NTD programmes post-EVD and proposed strategies to overcome them^a

Lack of health personnel

Reduction in health care personnel (due to migration and EVD deaths) may reduce ability of countries to quickly re-implement large scale health programmes

A focus on training of health staff (pre and post-service) and the procurement of further funding for staff.

Lack of trust in the health system

A lack of trust in the system could lead to reduced participation (compliance being essential for NTD success) and consequently the critically needed volunteer distributors may not be available. This is regarded as potentially the most debilitating challenge.

Using methods of social mobilisation that worked during the EVD outbreak to improve trust and community ownership of the programmes and activities. Success of using this approach during EVD suggests that is likely to be successful in regaining trust.

Appropriateness of the social mobilization material?

Existing materials and strategies may not be optimized to ensure the people’s understanding and trust in the programmes post-EVD

Review and edit existing material and methods used to incorporate lessons learned from EVD and thus improve social mobilization.

Disruption to the logistical management of MDA

There may be a reduced ability to efficiently transport the required drugs and materials to the various distribution centres

Focus by central administration to improve the logistics and communication infrastructure; important as this impacts all public health programmes.

Misperceptions of individuals with chronic conditions caused by NTDs

There may be reluctance for patients with chronic conditions (such as hydrocele and lymphoedema, buruli ulcer and leprosy) to become involved in morbidity management activities due to fears related to their experiences during the EVD outbreak and continued social stigma

Development of an integrated disease management plan to identify improved ways of reaching patients and providing access to treatment; this should be been focused on increasing disease awareness and understanding in the communities.