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Community‐directed interventions strategy enhances efficient and effective integration of health care delivery and development activities in rural disadvantaged communities of Uganda
Author(s) -
Katabarwa M. N.,
Habomugisha P.,
Richards F. O.,
Hopkins D.
Publication year - 2005
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2005.01396.x
Subject(s) - onchocerciasis , disadvantaged , psychological intervention , community health , ivermectin , distribution (mathematics) , community development , community health workers , environmental health , medicine , health care , public health , nursing , business , economic growth , health services , population , veterinary medicine , immunology , economics , mathematical analysis , mathematics
Summary The community‐directed interventions (CDI) strategy achieved a desired coverage of the ultimate treatment goal (UTG) of at least 90% with ivermectin distribution for onchocerciasis control, and filled the gap between the health care services and the communities. However, it was not clear how its primary actors – the community‐directed health workers (CDHW) and community‐directed health supervisors (CDHS) – would perform if they were given more responsibilities for other health and development activities within their communities. A total of 429 of 636 (67.5%) of the CDHWs who were involved in other health and development activities performed better than those who were involved only in ivermectin distribution, with a drop‐out rate of 2.3%. A total of 467 of 864 (54.1%) of CDHSs who were involved in other health and development activities also maintained the desired level of performance. They facilitated updating of household registers ( P < 0.05), trained and supervised CDHWs, and educated community members about onchocerciasis control ( P < 0.001). Their drop‐out rate was 2.6%. The study showed that the majority of those who dropped out had not been selected by their community members. Therefore, CDI strategy promoted integration of health and development activities with a high potential for sustainability.