In the villages of Western Kenya, health breakthroughs have slowly but steadily begun making headlines. Parents once watched their children miss school because of relentless intestinal worms. The adults missed days of work due to discomfort brought about by these Neglected Tropical Diseases (NTDs), particularly Bilharzia and Intestinal Worms.
After listening to their local community health promoters (CHPs), healthcare workers, attending village barazas, and simplified radio messages, their lives have changed for the better. Today, most children are back in school, the villages are open defecation-free, and generally, the community is healthier. This is a true manifestation of the revolution of community engagement in the fight against NTDs.
Last year, an annual assessment exercise was conducted by the African Institute for Health and Development (AIHD) and the Ministry of Health to evaluate the level of awareness, knowledge, risk perceptions, impact of sensitisation, communication channels, behavioural practices, and/or changes, gaps, and lessons associated with intestinal worms and bilharzia in the communities.
This study revealed that there was a high adoption of safe practices, with over 92 percent of the study respondents in Busia, Vihiga, Bungoma, and Trans Nzoia reportedly swallowing deworming tablets during the last Mass Drug Administration (MDA) exercise.
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With many Kenyans at risk of Bilharzia and intestinal worms, community-centered action is becoming the backbone of the journey to eliminate these diseases by 2030. People-led interventions, powered by continuous health messaging, are transforming NTD control from a top-down campaign into a community-led initiative.
NTDs are often called “diseases of neglect” for a reason. They thrive in areas where poverty, poor sanitation and hygiene, unsafe water, and poor health systems intersect. In the lake regions and farming communities of western Kenya, fishermen have been left too tired to cast nets, farmers have missed planting seasons, and children are stuck at home, driving families deeper into poverty and a tough cycle of struggle.
Over the years, the response to combating NTDs has often been technical. While lifesaving, these efforts sometimes ignore the local realities, restrictions and beliefs. People will not swallow a drug they know nothing about.
They will not boil water before consumption or dig pit latrines if, over the years, it has worked ‘fine’ for the previous generations. These deep-rooted practices can only be changed if the community feels listened to. This is where continuous social behaviour change communication (SBCC) and community engagement change the scene.
Evidence shows that when communities lead, solutions stick. Community ownership turns awareness into action. Pastors, imams, youth leaders, CHPs, boda boda leaders, and other change agents have become trusted neighbours and messengers. These agents have helped community members understand how NTDs are spread and how they can stop them.
This has been made possible through continuous health messaging, in the form of chief barazas, church and school gatherings, among others. Simple, repeated messages disseminated in local languages, through voices that people recognise, have greatly contributed to the growth of a sense of ownership by the community.
SBCC is much more than a poster or a radio spot. It is about sustaining a multilayered conversation. When morning radio spots explain these diseases in local languages, neighbours narrate success stories, and youth groups use humor to perform skits in public places, they contribute to demystifying NTDs and encourage behaviour change.
The results of these efforts are felt at home, in class, and on farms. The impact reaches every corner of daily life, from classrooms, homes, to farms. In schools where deworming has been consistently paired with health education, teachers have noted children showing up more regularly, focused, and eager to learn.
Some may worry that deep community engagement is too costly or slow, but the truth is that neglecting it drains far more resources. These diseases rob families of income, overwhelm health facilities, and weaken society’s potential.
Dr Amuyunzu is Founder Director and Technical Advisor, African Institute for Health and Development
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By Mary Amuyunzu Nyamongo