During mass drug administration (MDA), medication is offered to every person in a district, province, or region, regardless of whether or not they have signs of scabies. The medication primarily used for the MDA is called ivermectin. Ivermectin is widely-used and safe, it is available in tablet form and can be easily administered by community health workers in rural and remote areas. People ineligible to receive ivermectin, such as small children and pregnant women, are offered permethrin cream to apply to the entire body.
Public health teams engage with each community to discuss the importance of participating in the MDA and discuss any concerns raised about potential risks. These teams work with local community leaders and health workers to determine the best strategy for reaching the wider local population, such as visiting each household or workplaces or gathering the community in a meeting place. These community partnerships are critical to the success of the program.
Community based MDA for scabies is a straight-forward and efficient strategy. There are short and long-term health and social benefits of reducing the burden of scabies for all levels of society and cost benefits for the health system. Treating scabies in the community reduces admissions into already stressed health facilities and lowers medical costs for patients needing expensive care for skin and soft tissue infections.
In addition to MDA, WSP takes a health system strengthening approach. The aim is to ensure the communities are well informed on the causes and treatment for scabies and the health system has the capacity to monitor and treat any remaining cases after the MDA. Our approach is to establish a sustainable program within the Ministries of Health to ensure controlling scabies and its complications is part of the primary health care package.