Gender and neglected tropical disease front-line workers: Data from 16 countries

PLoS One. 2019 Dec 19;14(12):e0224925. doi: 10.1371/journal.pone.0224925. eCollection 2019.

Abstract

Background: Delivery of preventive chemotherapy (PC) through mass drug administration (MDA) is used to control or eliminate five of the most common neglected tropical diseases (NTDs). The success of an MDA campaign relies on the ability of drug distributors and their supervisors-the NTD front-line workers-to reach populations at risk of NTDs. In the past, our understanding of the demographics of these workers has been limited, but with increased access to sex-disaggregated data, we begin to explore the implications of gender and sex for the success of NTD front-line workers.

Methodology/principal findings: We reviewed data collected by USAID-supported NTD projects from national NTD programs from fiscal years (FY) 2012-2017 to assess availability of sex-disaggregated data on the workforce. What we found was sex-disaggregated data on 2,984,908 trainees trained with financial support from the project. We then analyzed the percentage of males and females trained by job category, country, and fiscal year. During FY12, 59% of these data were disaggregated by sex, which increased to nearly 100% by FY15 and was sustained through FY17. In FY17, 43% of trainees were female, with just four countries reporting more females than males trained as drug distributors and three countries reporting more females than males trained as trainers/supervisors. Except for two countries, there were no clear trends over time in changes to the percent of females trained.

Conclusions/significance: There has been a rapid increase in availability of sex-disaggregated data, but little increase in recruitment of female workers in countries included in this study. Women continue to be under-represented in the NTD workforce, and while there are often valid reasons for this distribution, we need to test this norm and better understand gender dynamics within NTD programs to increase equity.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Chemoprevention
  • Female
  • Global Health
  • Humans
  • Male
  • Mass Drug Administration / methods*
  • Neglected Diseases / drug therapy
  • Neglected Diseases / prevention & control*
  • Sex Factors
  • Sexism
  • Tropical Medicine / methods*
  • Tropical Medicine / trends

Grants and funding

This publication was made possible thanks to funding from the US Agency for International Development (USAID) under the ENVISION project and the Act to End NTDs | East program led by RTI International under cooperative agreements No. AID-OAA-A-11-00048 and No. 7200AA18CA00040, and by the End Neglected Tropical Diseases in Africa (END in Africa) project and Act to End NTDs | West program led by FHI 360 under cooperative agreements No. AID-OAA-A-1000050 and No. 7200AA18CA00011. The contents are the responsibility of the authors and do not necessary reflect the views of USAID or the United States government. Other than the personal contributions of CLS, who provided input while employed by USAID (and therefore listed as a coauthor on this article), the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated. JDK receives partial salary support from RTI International as a visiting scholar in RTI’s international development group.