Table 1 Themes, challenges and opportunities identified

1. Potential of stakeholder’s involvement and participation in resource mobilization for MDA delivery with a focus on ACSM activities,

i. Low involvement of stakeholders and partners in MDA for LF

ii. Communication or lack of communication on MDA for LF to stakeholders

iii.

- Inform to stakeholders early

- Plan the MDA for LF with stakeholders

- Share roles

2. The need for innovative approaches and strategies to improve ACSM preparation, development and dissemination and

i. Insufficient knowledge on the transmission cycle thus perpetuating myths and misconceptions

ii. The IEC materials are few, not in the native language and they are delivered late

- Enhanced Community meetings (Barazas) with awareness creation by health officers

- Mobile phones using WhatsApp and radio programmes

3. Challenges affecting effective implementation of ACSM activities in MDA for LF

i. Individual decision not to take drugs

ii. Pressure to meet set targets

iii. MDA Planning, implementation and follow-up

- Increase awareness creation using innovative strategies

- Increase the MDA time from 3 days to five days

- MDA for LF awareness should be continuous

4. Challenges with morbidity management and disability prevention services.

i. Patients fear surgery thus refuse their names to be recorded

ii. Insufficient facilities such as functional theatre to execute the surgeries and wards to admit patients after surgeries

iii. Insufficient personnel to perform surgeries

- County governments to expand and equip theatres

- Patients to be encouraged to have the operations