Community-directed interventions strategy enhances efficient and effective integration of health care delivery and development activities in rural disadvantaged communities of Uganda

Tropical Medicine & International Health
Volume 10 Issue 4 Page 312 - April 2005
doi:10.1111/j.1365-3156.2005.01396.x

M. N. Katabarwa, P. Habomugisha, F. O. Richards Jr and D. Hopkins
The Carter Center, Atlanta GA, USA

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.

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