Peer-Reviewed Publications
Engaging community influencers to increase mass drug administration uptake for neglected tropical diseases in South Sudan — by Sara Jane Renfroe, Abuk Peter, Taroub Harb Faramand, Elaina B Rukab, Caroline Pensotti, Shelby Roberts, James Nyara, Sara Pappa, Yak Yak Bol, Emmanuel Ssegawa, Liya Assefa, Sira Camara; International Health, July 2026
South Sudan is endemic for all preventive chemotherapy neglected tropical diseases, and counties including Awerial, Kapoeta North and Kajo-Keji face persistent transmission and high absenteeism and refusal rates for mass drug administration (MDA). To identify barriers, we conducted a mixed-methods root cause analysis (combining a quantitative KoboToolbox survey with focus group discussions and key informant interviews), using WI-HER’s identify, design, apply/assess, record, and expand (iDARE) methodology with gender equity and social inclusion (GESI) at its core. Fundamental to our approach, we trained community-selected influencers (local leaders and respected community figures) in GESI principles and behavior change techniques, supporting them to co-design and implement locally contextualized solutions. Following influencer-led engagement in Awerial County, cohort members demonstrated a 90.9% improvement in MDA uptake. This pilot project demonstrates that sustainable increases in MDA coverage require a community-grounded approach that integrates localized barrier analysis, GESI-informed influencer training and ongoing community engagement.
Transforming health systems through women’s leadership: Lessons from South Sudan — by Stacey Nandudu, Sara Jane Renfroe, Elaina B. Rukab, and Taroub Harb Faramand; SSM – Health Systems, December 2026
Despite women comprising the majority of the global health workforce, they remain underrepresented in leadership positions, particularly in fragile and conflict-affected settings where structural constraints limit opportunities for locally led change. This is especially the case for women in low- and middle-income countries, and represents a major constraint not only in ensuring equitable health service provision, but is also in contradiction to UN Sustainable Development Goal 5.5: “Ensure women’s full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic, and public life.” This commentary utilizes feminist institutionalism and the lens of gender transformative leadership to examine how decolonial mentorship applied real-time during ongoing programming can generate gender-transformative change in fragile health systems. We examine the leadership trajectory of Dr. Abuk Peter, a South Sudanese surgeon who supported the Ending Neglected Diseases (END) Fund’s Accelerate, Resilient, Innovative, and Sustainable Elimination (ARISE) project from 2024 to 2026 to increase access and utilization of mass drug administration (MDA) for neglected tropical diseases (NTDs) across four counties with persistently high burdens of trachoma, lymphatic filariasis, and onchocerciasis. Using her experience as an illustrative case, this paper explores how sustained decolonial mentorship, rooted in WI-HER’s Identify–Design–Apply/Assess–Record–Expand (iDARE) methodology and Social Cognitive Theory, enabled the development of self- and collective efficacy among health system actors to enact structural change within a highly gendered institution. Furthermore, through Dr. Peter’s own process of growing as a leader and due to her interaction with national, sub-national and community-level stakeholders, we contend that this type of leadership development can address intersectional inequities within gendered institutions, addressing the underlying power dynamics and structures which prevent gender-transformative change.
Gender equity and social inclusion in mass drug administration for neglected tropical diseases in post-conflict South Sudan — by Sara Jane Renfroe, Abuk Peter, Caroline Pensotti, Shelby Roberts, James Nyara, Sara Pappa, Yak Yak Bol, Liya Assefa, Sira Camara, and Taroub Harb Faramand; Dialogues in Health, December 2026
Despite the implementation of ongoing mass drug administration (MDA) campaigns, South Sudan remains endemic for six Preventive Chemotherapy Neglected Tropical Diseases (PC-NTDs); this persistent endemicity is attributed to complex sociocultural barriers and healthcare delivery challenges. Integrating gender equity and social inclusion (GESI) is essential to identify barriers to equitable MDA delivery and develop targeted, inclusive solutions. This study includes a assessment of barriers among adults who did not receive MDA during the most recent campaign, which employed WI-HER’s iDARE methodological framework, integrating root cause analysis and qualitative interviews with a total of 256 participants in Awerial County. The study explored factors such as gender roles, cultural norms, and access disparities affecting MDA participation among marginalized populations including nomadic pastoralists, women, internally displaced persons, and persons with disabilities. Findings revealed persistent barriers including geographical challenges, limited awareness, mobility constraints, and sociocultural norms that differentially impact population groups. Gender-specific risk factors were identified, with men exposed through cattle farming and hunting activities, while women faced risks through domestic responsibilities like water collection. Although most respondents (70.4%) perceived equal healthcare access, notable disparities were found in MDA participation, particularly among mobile populations. The study underscores the importance of integrating GESI principles into NTD programming to enhance equitable participation of everyone at risk of the disease and address inequities in access to interventions. Recommendations include gender-responsive strategies, community-driven engagement, and targeted training for MDA implementers. Embedding GESI into NTD programming is essential for equitable MDA coverage and sustainable elimination in post-conflict settings.
Integrating gender equity and social inclusion into forecasting and supply planning (FSP): a policy commentary – by Taroub Harb Faramand, Sara Pappa, Sara Jane Renfroe, and Laila Akhlaghi; International Health, March 2026
This policy commentary argues that forecasting and supply planning (FSP) for immunization systems must integrate gender equity and social inclusion (GESI) to bridge the gap between vaccine supply and actual utilization. While FSP traditionally focuses on supply-side efficiency, this narrow approach risks perpetuating inequities by leaving systematically excluded populations invisible in data and planning processes. Drawing on experience from the Immunization Collaborative Supply Planning Strengthening project, we demonstrate how contextual factors including gender dynamics, mobility patterns, seasonality and conflict shape vaccination demand among marginalized communities. The commentary outlines key practice implications, including strengthening supply–demand collaboration, embedding GESI expertise into FSP teams and improving data disaggregation. We conclude that this integration is essential to transforming forecasting into an inclusive mechanism that ensures equitable immunization access.
Applying the iDARE Methodology in Uganda, Kenya, and Tanzania to Improve Health Outcomes During the COVID-19 Pandemic – By Amanda Ottosson, Joyce Draru, Luseka Mwanzi, Stella Kasindi Mwita, Sara Pappa, Krista Odom, and Dr. Taroub Harb Faramand; Global Health: Science and Practice, June 2022
This field action report shares how WI-HER enabled locally-led solutions and achieved improved health outcomes in three countries despite challenges posed by the Covid-19 pandemic. WI-HER’s innovative iDARE methodology–a 5-step process–was applied in each country, as it fosters socio-normative transformation that can result in sustainable community-based change.
Improving Viral Load Suppression Among Men and Children Active in Care Through Community-Designed and Led Solutions: Protocol for Retrospective Closed Cohort Study in Eastern Uganda By Krista Odom, Amanda Ottosson, Joyce Draru, Harriet Komujuni; Esther Karungi Karamagi Nkolo, and Dr. Taroub Harb Faramand; JMIR Research Protocols, April 2022
After WI-HER applied its iDARE methodology in Uganda to address low rates of viral load suppression (VLS) in people living with HIV, the authors of this retrospective cohort study measured the implementation impact of iDARE, both at the facility and community levels.
Illustrative Publications
Local Solutions, Global Impact: Building a Business Focused on Locally-Led Development – By Liz Hall; SBAIC.org; July 2024
WI-HER’s commitment to locally-led development transforms how global development and public health initiatives are designed and implemented. Learn why Dr. Taroub Harb Faramand started WI-HER and how her approach to community engagement drives sustainable, inclusive solutions worldwide.
Building the Monitoring, Evaluation, and Learning (MEL) Capacity of Healthcare Workers in Nigeria By Shauna-Kaye Rowe and Annie Cameron; SBAIC.org; September 2023
Find out how WI-HER, under the USAID Integrated Health Program, helped improve GBV case identification by 265% through a Grants Under Contract (GUC) mechanism and Training of Trainers (ToT) activity. Our partnerships and trainings foster a multi-sectoral approach and contribute to building healthcare worker capacity for a stronger GBV response in Nigeria.
Leveraging Locally Designed and Led Solutions to Improve HIV Treatment Outcomes Among Men and Youth in Uganda By Elizabeth Kemigisha, Harriet Komujuni, and Amanda Ottosson; SBAIC.org; June 2022
WI-HER supported the Tororo District in Eastern Uganda to significantly improve viral load suppression (VLS) among men and youth actively enrolled in HIV care and treatment. Through the application of the iDARE methodology, the communities were able to identify influencers and co-create solutions to the challenges around improving VLS.
Empowering Local Youth Leaders in Nigeria to Increase Awareness and Support for Adolescent and Youth Services by Kenneth Goughnour, Allison Foster, and Elizabeth Kemigisha; SBAIC.org; February 2022
This article details how WI-HER develops local capacity in Nigeria to leverage and utilize locally available resources, advocate responsiveness to youth needs, and promote the utilization of the health system among their peers. WI-HER also addresses barriers preventing adolescents from gaining access to and utilizing services by empowering local youth leaders to advocate for enhanced integrated health services that meet their requirements.