Background Mass Drug Administration for malaria consists of administering antimalarial drugs to the whole population in a defined area, irrespective of infection status. The World Health Organization recommends it to reduce transmission in low transmission settings. To ensure that MDA is effective, at least 80% of the target population should be reached.

Methods Between December 2022 and February 2023, two rounds of programmatic MDA (pMDA) were implemented by the Mozambican National Malaria Control Program in the administrative post of Chidenguele (Manjacaze district, Gaza province), where the estimated population is around 59,000. To evaluate the coverage, adherence, acceptability, adoption and appropriateness of the pMDA delivery strategy, a cross-sectional community survey and a survey to the health staff involved in the implementation were conducted.

Results Data routinely-collected during the pMDA show that population programmatic coverage (individuals treated over total population) was 69.8% (41347/59271), while according to the cross-sectional survey, 73.9% (569/770) of respondents reported having taken the medication. 84.2% (648/770) of community respondents thought that the campaign could help decrease malaria in the community, and 91.3% (703/770) thought that taking the medication regardless of malaria infection was acceptable. Among community respondents that were aware of the pMDA campaign (686/770), 76.5% (525/686) stated they knew about its objectives. 88% (22/25) of surveyed health staff reported to be very willing to collaborate and comply with procedures and with the intervention prior to the start of the implementation and 73.1% (19/26) agreed that the designed intervention was adequate to meet the objectives of the program.

Conclusion Overall, the pMDA delivery strategy was accepted by both the community and the implementers. Community and stakeholder engagement were essential to ensure a successful campaign implementation.

Funding: This project is funded by the EDCTP2 Programme.