Primary Research Question: To explore the reasons behind never treatment during PC-NTDs MDA in Mali and provide evidence to support the development of an effective programmatic response, including a further quantitative assessment of the factors associated with never treatment and recommendations for qualitative assessments of never treatment.

Secondary Research Question: 
1) To identify the reasons for never treatment amongst mobile populations in Mali 
2) To identify the barriers/facilitators to treatment access during MDA for individuals who are never treated
3) To provide recommendations based on stakeholder input for the development of a standardized approach for an effective programmatic response.
4) To provide recommendations on a qualitative investigation of never treatment
5) To draft a standardized question that reflects reasons identified for never treatment

The NTD program in Mali has been highly affected by growing conflict and regional instability over the past five years. Earlier research supported by COR-NTD (200D Mali) indicated that 12% of nomads and other mobile populations were never treated during MDA with more than 35% of the participants stating that they did not participate in the last MDA campaign. The study team proposes conducting 12 focus groups and 24 in-depth interviews with a variety of mobile populations and health care workers in two health districts of Mali: Tominian and Kalaban-coro. The mobile populations are divided into three categories: economic migrants, internally displaced persons, and nomads. Following this formative research, the study team aims to draft and pilot a standardized, closed-ended question on reasons for NT for inclusion in programmatic questionnaires and surveys. They also aim to use this research as a springboard to develop a rapid qualitative assessment for never treatment in mobile populations.