Community Perspective on Feasibility of Malaria Mass Drug Administration: A Qualitative Evidence from the Eastern Region of Ghana

Background Malaria remains the leading cause of morbidity and mortality in Ghana, particularly in rural high-burden communities. Mass drug administration (MDA) has re-emerged as a complementary strategy to reduce transmission, yet community acceptability and implementation challenges remain underexplored. Methods We conducted focus group discussions (FGDs) with community participants in Pokrom subdistrict in the Eastern Region of Ghana following pilot MDA interventions. Discussions explored perceptions of malaria burden, MDA effectiveness, adverse events, health-seeking behaviour, and community-level acceptability. Transcripts were thematically analysed using a hybrid inductive–deductive approach. Results Participants consistently mentioned that malaria was the most pressing health concern in the subdistrict prior to the implementation of the MDA. FGD participants reported substantial reduction in malaria frequency and household expenditure on treatment following MDA, with some households reporting a shift from frequent monthly episodes to rare or absent illness. Side effects of the MDA drugs, including dizziness, abdominal pain, and weakness were reported, though mostly transient in addition to inadequate sensitization and negative messaging from some health workers initially undermined uptake. Most participants expressed willingness to participate in future MDA rounds due to reduced health and financial burdens. Participants recommended the need for more effective sensitization, improved drug delivery logistics, and enhanced monitoring of side effects during implementation as means to enhance drug uptake. Conclusions MDA was widely perceived as beneficial in reducing malaria and household health seeking related financial burden in rural Ghana, reinforcing evidence of its potential as a complementary malaria elimination tool. Effective communication, robust pharmacovigilance, and community ownership are critical to sustaining high uptake. Addressing barriers such as side effects and misinformation may enhance MDA drugs uptake. These findings provide additional insights for policymakers to consider scaling up of MDA in high-burden West African contexts.