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As directed by the Sustainable Development Goals, the principle of ‘leave no one behind’ is a pivotal approach to improving coverage and equity within neglected tropical disease (NTD) programme activities. Displaced populations are an at-risk group who are often excluded from treatment and services due to their mobility and marginalisation. This article reflects on the experiences of two countries within the Ascend programme, which responded to the need to strategise and implement approaches that lead to more inclusive and accessible programme activities for displaced populations. With the increasing rate of insecurity and the threat of natural disasters, which is resulting in the displacement of communities and persons eligible for NTD treatment, the ‘leave no one behind’ approach is needed to move closer towards the NTD elimination agenda and to ensure effective coverage thresholds are met.

Innovation plays a critical role in progress towards achievement of the World Health Organization's road map for neglected tropical diseases 2021–2030. As disease prevalence decreases, the cost to identify and treat remaining cases goes up. Additionally, as programmes move to the surveillance phase, diagnostic tests need to be highly sensitive and affordable. Until the early end to the Ascend West and Central Africa programme, the Ascend Learning and Innovation Fund supported five projects from 2019 to 2021. Designed for innovation, the fund encompassed a range of activities, including operational research, product development and social behavioural change. This flexibility allowed innovation to bridge the gap between strategic policy and practical implementation, piloting and proving business models to respond to information found through Ascend.

Background Schistosomiasis affects nearly 220 million people worldwide, mainly in Sub-Saharan Africa (SSA). Preventive chemotherapy (PC) treatment, through regular mass-drug administration (MDA) of Praziquantel tablets remains the control measure of choice by Ministries of Health. Current guidelines recommend that 75% of school-aged children receive treatment. Many programmes, however, struggle to achieve this target. Given the risk of high reinfection rates, attaining sustained high levels of treatment coverage is essential. This study provides a comprehensive review of the barriers and facilitators operating at different levels of analysis, from the individual to the policy level, conditioning the uptake of PC for schistosomiasis in SSA. Methodology/Principal findings A systematic literature search was conducted in several databases for publications released between January 2002 and 2019 that examined factors conditioning the uptake of Praziquantel in the context of MDA campaigns in SSA. A total of 2,258 unique abstracts were identified, of which 65 were selected for full text review and 30 met all eligibility criteria. Joanna Briggs Institute’s Critical Appraisal and the Mixed-Methods Assessment tools were used to assess the strength of the evidence. This review was registered with PROSPERO (CRD42017058525). A meta-synthesis approach was used. Results indicated publication bias, with the literature focusing on East African rural settings and evidence at the individual and programmatic levels. The main influencing factors identified included material wellbeing, drug properties, knowledge and attitudes towards schistosomiasis and MDAs, fears of side effects, gender values, community and health systems support, alongside programme design features, like training, sensitisation, and provision of incentives for drug-distributors. The effect of these factors on determining Praziquantel uptake were explored in detail. Conclusions/Significance Multiple determinants of treatment uptake were found in each level of analysis examined. Some of them interact with each other, thus affecting outcomes directly and indirectly. The promotion of context-based transdisciplinary research on the complex dynamics of treatment uptake is not only desirable, but essential, to design effective strategies to attain high levels of treatment coverage., Author summary Schistosomiasis is a parasitic infection that affects nearly 220 million people worldwide. Long-term effects include anaemia, growth stunting, bladder cancer and infertility. Currently, the main approach to schistosomiasis control involves mass preventive chemotherapy treatment. Current guidelines recommend treating 75% of school-aged children but many programmes struggle to achieve this target. This study conducted a comprehensive review of factors conditioning the uptake of treatment in Sub-Saharan Africa across different levels of analysis: individual, interpersonal, organisational, community and policy. This examination showed, first, that the literature suffers of publication bias, with most studies based in rural East African sites and focusing in discussing individual- and policy-level factors. It indicated as well that people’s livelihoods, food security, and school-enrolment, alongside knowledge and attitudinal factors influenced treatment uptake at the individual level. Various contextual factors concerning interpersonal relations, organisations’ resources, and prevalent socio-cultural features (e.g., gender) further shaped people’s responses to MDA campaigns. Finally, it was observed that the effectiveness of programme-level decisions on sensitisation, training, and drug-delivery strategies were constantly re-shaped by mediating factors operating at lower levels of analysis. We conclude that the promotion of context-based transdisciplinary research is essential to design effective strategies to promote sustainable high levels of treatment coverage.

Despite the Amazon’s natural wealth, food insecurity is a major concern among indigenous communities. Yet, little is known about the socio-ecological dynamics shaping the contributions of local ecosystems to food security. In this study we examine how ecological features interact with normative structures, lifestyles, and livelihoods to expose indigenous peoples to food shortages and how they attempt to cope with worsening food insecurity conditions through participatory exercises with ten indigenous communities along the Caqueta River, Colombia. Our results indicate that traditional food systems are sensitive to human and natural capital disruptions. However, severe food insecurity is prevented by the combination of a well-preserved environment and traditional social institutions, which facilitates widespread access to wild foods, farmland, environmental knowledge, supportive relations, and labour. Nevertheless, traditional adaptations appear insufficient when food insecurity results from health shocks. Our findings highlight the need for interventions that pursue conservation objectives whilst promoting social structures supporting resilience.

Although it has been hypothesized that men and women vary in the way they value ecosystem services, research on ecosystem services rarely incorporates a gender dimension. We conducted research with nine indigenous communities in the Colombian Amazon to understand which ecosystem services men and women perceive as most important for their wellbeing and to rank them according to locally-defined criteria of importance. Participants identified a total of 26 ecosystem services and 20 different ranking criteria. Ecosystem services such as land for agricultural fields (a supporting service), and provision of fish and medicinal plants were equally important for both men and women. Wild fruits and resources to make handicrafts were more frequently mentioned by women, whereas timber, materials for making tools and coca leaves were more frequently mentioned by men. There were also differences in the criteria used to value ecosystem services, with 11 criteria mentioned by both men and women, five mentioned exclusively by women and another four only by men. Our results suggest that taking gender differences into account in ecosystem services assessments may result in the prioritization of different services in conservation and sustainable development programs, and may lead to different outcomes for ecosystem service provision and local livelihoods.

Background Wildlife has been traditionally used by forest communities as a source of protein, and the Peruvian Amazon is no exception. The articulation of colonist and indigenous communities to urban centers and markets results in changes in livelihood strategies and impacts on wildlife populations. To address the threat of overhunting and forest conversion, we provide a generalized characterization of colonist and indigenous communities and their hunting activities near Pucallpa, Ucayali, Peru. Methods A semi-structured household survey was conducted to characterize hunters and describe their prey collections. The data were analyzed by conducting a Kruskal-Wallis test, a multiple regression analysis, and by estimating the harvest rate (H). Results Less wealthy households were more actively engaged in hunting for food security and as a livelihood strategy. Additionally, older hunters were associated with higher hunting rates. Although the percentage of hunters was relatively low, estimated hunting rates suggest overharvesting of wildlife. Lowland pacas (Cuniculus paca) were the most frequently hunted prey, followed by red brocket deer (Mazama americana) and primates. While hunting intensity was not significantly different between indigenous and colonist communities, hunting rate disparities suggest there are different types of hunters (specialized vs. opportunistic) and that prey composition differs between communities. Conclusion Close monitoring of wildlife populations and hunting activities is ideal for more accurately determining the impact of hunting on wildlife population and in turn on forest health. In lack of this type of information, this study provides insight of hunting as a shifting livelihood strategy in a rapidly changing environment at the forest/agriculture frontier. Electronic supplementary material The online version of this article (10.1186/s13002-018-0247-2) contains supplementary material, which is available to authorized users.

Over the last two decades indigenous peoples in the lower Caquetá River basin in Colombia have experienced detrimental changes in the provision of important ecosystem services in ways that have significant implications for the maintenance of their traditional livelihoods. To assess these changes we conducted eight participatory mapping activities and convened 22 focus group discussions. We focused the analysis on two types of change: (1) changes in the location of ecosystem services provisioning areas and (2) changes in the stock of ecosystem services. The focal ecosystem services include services such as provision of food, raw materials and medicinal resources. Results from the study show that in the past two decades the demand for food and raw materials has intensified and, as a result, locations of provisioning areas and the stocks of ecosystem services have changed. We found anecdotal evidence that these changes correlate well with socio-economic factors such as greater need for income generation, change in livelihood practices and consumption patterns. We discuss the use of participatory mapping techniques in the context of marginalized and data-poor regions. We also show how this kind of information can strengthen existing ecosystem-based management strategies used by indigenous peoples in the Colombian Amazon.

El presente texto intenta contribuir al debate actual sobre los factores que condicionan el respaldo hacia un sistema de gobierno democrático en el Perú. Específicamente, este estudio abordará dos preguntas: (i) ¿qué tan sólido es el apoyo por la democracia en la actualidad? y (ii) ¿en qué medida dicho apoyo está determinado por los problemas materiales de la población? Para abordar estas preguntas presentaremos una revisión exhaustiva de la literatura internacional y nacional así como una exploración teóricamente fundamentada de datos estadísticos para la primera mitad de la década de 2000 en el Perú. Esta discusión nos permitirá, además, resaltar ciertos elementos metodológicos que pueden servir de ayuda para futuras investigaciones sobre el tema.