Between Policy and Practice: Multi-level Perspectives on Implementing South Africa’s Neglected Tropical Disease Master Plan
1
Public Health, University of KwaZulu-Natal, Durban, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A3252
ABSTRACT
INTRODUCTION:
Significant progress has been made towards eliminating Neglected Tropical Diseases (NTDs) globally, with 47 countries having eliminated at least one NTD. However, these diseases continue to affect over one billion people globally. The World Health Organization (WHO) launched its 2021-2030 roadmap; translating global policy into national action remains a significant challenge. In South Africa, the development of a national NTD Master plan (2019-2025) reflects growing policy attention to NTDs, yet gaps in translating policy to practice persist across levels of the health system. This study examined multi-level stakeholder perspectives on the barriers and facilitators to translating the policy into an actionable plan.
METHODS:
Semi-structured interviews were conducted between June and August 2025 with 13 purposively sampled participants drawn across five stakeholder groups at different governance levels (national (n=3), provincial (n=1), institutional/technical advisor (n=1), district (n=6), and facility (n=2)), selected based on their direct involvement in the development or implementation of South Africa's NTD master plan. Non-participant observation was conducted during a national communicable disease control stakeholder meeting. Data from interviews and observations were analysed thematically, with data coded iteratively through multiple cycles of analysis using a hybrid inductive-deductive approach.
RESULTS:
Preliminary analysis indicates that the implementation of South Africa’s NTD Master Plan is occurring in a context where the policy remains in draft form and only one major objective, mass drug administration (MDA) for schistosomiasis, has been piloted. Early indications suggest a disconnect between national-level policy design and frontline implementation, with district and facility stakeholders reporting limited involvement in the development of the Master Plan.
CONCLUSIONS:
The NTD Master Plan remains in draft, creating ambiguity about implementation obligations and contributing to inconsistent interpretation and execution across care levels.
Significant progress has been made towards eliminating Neglected Tropical Diseases (NTDs) globally, with 47 countries having eliminated at least one NTD. However, these diseases continue to affect over one billion people globally. The World Health Organization (WHO) launched its 2021-2030 roadmap; translating global policy into national action remains a significant challenge. In South Africa, the development of a national NTD Master plan (2019-2025) reflects growing policy attention to NTDs, yet gaps in translating policy to practice persist across levels of the health system. This study examined multi-level stakeholder perspectives on the barriers and facilitators to translating the policy into an actionable plan.
METHODS:
Semi-structured interviews were conducted between June and August 2025 with 13 purposively sampled participants drawn across five stakeholder groups at different governance levels (national (n=3), provincial (n=1), institutional/technical advisor (n=1), district (n=6), and facility (n=2)), selected based on their direct involvement in the development or implementation of South Africa's NTD master plan. Non-participant observation was conducted during a national communicable disease control stakeholder meeting. Data from interviews and observations were analysed thematically, with data coded iteratively through multiple cycles of analysis using a hybrid inductive-deductive approach.
RESULTS:
Preliminary analysis indicates that the implementation of South Africa’s NTD Master Plan is occurring in a context where the policy remains in draft form and only one major objective, mass drug administration (MDA) for schistosomiasis, has been piloted. Early indications suggest a disconnect between national-level policy design and frontline implementation, with district and facility stakeholders reporting limited involvement in the development of the Master Plan.
CONCLUSIONS:
The NTD Master Plan remains in draft, creating ambiguity about implementation obligations and contributing to inconsistent interpretation and execution across care levels.
| eISSN: | 2654-1459 |
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