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

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

Erica A Shoemaker  1 , Kelly Dale  2 , Daniel A Cohn  3 , Maureen P Kelly  1 , Kathryn L Zoerhoff  1 , Wilfrid E Batcho  4 , Clarisse Bougouma  5 , Georges B Nko'Ayissi  6 , Aboulaye Meite  7 , Benjamin Marfo  8 , André Goepogui  9 , Marc-Aurele Telfort  10 , Lita Renata Sianipar  11 , Mahamadou Traore  12 , Pradip Rimal  13 , Djibo Aichatou Alfari  14 , Chukwuma Anyaike  15 , Fatou N Badiane  16 , Ibrahim Kargbo-Labour  17 , Upendo J Mwingira  18   19 , Marcel S Awoussi  20 , Rachel D Stelmach  1 , Carly L Smith  21 , Jennifer Arney  3 , Taroub Harb Faramand  2 , Diana M Stukel  3 , Bolivar Pou  3 , Lisa A Rotondo  1 , John D Kraemer  1   22 , Margaret C Baker  1
Affiliations
Review

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

Erica A Shoemaker et al. PLoS One. .

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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Percent of available sex-disaggregated data.
This graph shows the percent of trainees that attended trainings where sex-disaggregated data was collected by fiscal year.
Fig 2
Fig 2. Percentage trained by country and job category in FY17.
This graph represents the percentage of males and females trained in FY17 by country and job category. The total number of trainees are also listed by country and job category. No trainees participated in trainer/supervisor trainings for Indonesia in FY17.
Fig 3
Fig 3. Percentage of females trained as trainers/Supervisors from FY12-FY17 by country.
This collection of graphs shows the percentage of females trained as trainers/supervisors from FY12-FY17 by country. A dashed line is included at 50% for reference.
Fig 4
Fig 4. Percentage of females trained as drug distributors from FY12-FY17 by country.
This collection of graphs shows the percentage of females trained as drug distributors from FY12-FY17 by country. A dashed line is included at 50% for reference.
See this image and copyright information in PMC

References

    1. World Health Organization; Preventive chemotherapy in human helminthiasis. Geneva, Switzerland; 2006.
    1. WHO. Update on the global status of implementation of preventive chemotherapy (PC). [Internet]. 2019. Available from: https://www.who.int/neglected_diseases/preventive_chemotherapy/PC_Update...
    1. Baker M. Who are the NTD drug distributors? An analysis of platforms used for mass drug administration across multiple countries in symposuim 106 Community Providers for Neglected Tropical Disease Control: The “Building Blocks” for Program Success. ASTMH Conference 2016; 2016.
    1. Vouking MZ, Tamo VC, Tadenfok CN. Contribution and performance of female Community-Directed Distributors in the treatment of onchocerciasis with Ivermectin in Sub-Saharan Africa: a systematic review. Pan African Medical Journal [Internet]. 2015 [cited 2019 Feb 24];20. Available from: http://www.panafrican-med-journal.com/content/article/20/188/full/ - PMC - PubMed
    1. World Health Organization. Delivered by women, led by men: A gender and equity analysis of the global health and social workforce. Geneva; 2019. (Human Resources for Health Observer Series No. 24).

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