Globally, an estimated 24% of the population is infected with STH, resulting in substantial morbidity and economic losses. In recent decades, STH control has largely benefited from mass drug administration (MDA) campaigns implemented for the elimination of lymphatic filariasis (LF). Malawi is among 18 countries that have completed LF MDA, contributing to a marked reduction in STH prevalence. An additional 27 countries aim to complete LF MDA by 2030 in line with WHO targets. 

In Malawi, a five-year annual treatment campaign using albendazole and ivermectin was implemented in STH-endemic areas but ended in 2014. Ongoing control efforts have focused on deworming school-aged children in areas with prevalence above 1%. However, challenges persist, including high reinfection rates between treatment rounds, limited WASH (water, sanitation, and hygiene) infrastructure, and uncertainty regarding the sustainability of drug donations beyond 2030, as pharmaceutical support for LF-related MDA phases out. These factors threaten the progress achieved in STH control and highlight the need for innovative, sustainable strategies to maintain low infection rates. 

This research seeks to explore sustainable community- and system-level approaches to sustain STH control beyond drug donation programmes. The study will generate locally grounded evidence to inform national policy, strengthen integration of STH control within existing health systems, and build capacity for long-term program sustainability.