Journal
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE
Volume 104, Issue 4, Pages 265-272Publisher
OXFORD UNIV PRESS
DOI: 10.1016/j.trstmh.2009.10.012
Keywords
Community-directed; Classic CDTI; Kinship enhanced; Community distributors; Treatment coverage; Women's involvement
Funding
- Carter Center, Uganda
Ask authors/readers for more resources
The challenges of community-directed treatment with ivermectin (CDTI) for onchocerciasis control in Africa have been: maintaining a desired treatment coverage, demand for monetary incentives, high attrition of community distributors and low involvement of women. This study assessed how challenges could be minimised and performance improved using existing traditional kinship structures. In classic CDTI areas, community members decide upon selection criteria for community distributors, centers for health education and training, and methods of distributing ivermectin. In kinship enhanced CDTI, similar procedures were followed at the kinship level. We compared 14 randomly selected kinship enhanced CDTI communities with 25 classic CDTI communities through interviews of 447 and 750 household members and 127 and 64 community distributors respectively. Household respondents from kinship enhanced CDTI reported better performance (P < 0.001) than classic CDTI on the following measures of program effectiveness: (a) treatment coverage (b) decision on treatment location and (c) mobilization for CDTI activities. There were more female distributors in kinship enhanced CDTI than in classic CDTI. Attrition was not a problem. Kinship enhanced CDTI had a higher number of community distributors per population working among relatives, and were more likely to be involved in additional health care activities. The results suggest that kinship enhanced CDTI was more effective than classic CDTI. (C) 2009 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available