Africa reports significant progress in community-directed health care

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Flag of Burkina Faso
Flag of Burkina Faso

African scientists Monday unveiled a new research that shows a doubling of treatment coverage of children suffering from malaria, when delivery of drugs was controlled by the local community themselves.

Other key findings of the research, announced at the 4th Primary Health Care conference which opened in Ouagadougou, Burkina Faso, include: The proportion of households possessing at least one insecticide-treated bed net to prevent mosquito bites approached the international target of 60%, despite shortage of nets.

Also, the findings show Vitamin A supplement coverage was significantly higher than sites without this process (community-directed treatment), reaching an average of 90% of eligible children, while Onchocerciasis (river blindness) annual treatment jumped from 10% to 74% of the populations studied.

Dr. Hans Remme, who oversaw the study design and execution, described the finding on Malaria treatment as “a dramatic improvement”.

“And what is really exciting is that each village determined how they would provide this care, who would do it and how,” added Dr. Remme, who is a research coordinator in the Special Programme for Research and Training in Tropical Diseases (TDR) based at WHO.

According to the research, while there were no additional costs to the regional and national health systems, the local communities spent many volunteer hours.

“The villagers were mainly motivated by the desire to contribute to the community, recognition, status, knowledge and skills gained,” TDR said in a statement.

The presentation of the report to the over 30 Ministers attending the conference is significant, since the Ouagadougou meeting is focusing on new approaches.

The research was requested by the African Programme for Onchocerciasis Control (APOC) to assess whether a community-based system launched in the 1990s to distribute a drug to prevent River Blindness (Onchocerciasis) could be used for other health conditions.

It shows small communities, each developing their own approach to delivering the River Blindness drug, ivermectin, did this so effectively the disease is now on its way to being eliminated.

The three-year research, which investigated a number of different types of care that communities could provide themselves, was conducted among 2-3 million people across Nigeria, Uganda and Cameroon during 2005-2007.

Based on the findings, APOC will now work to help expand into countries currently using this approach for river blindness alone, and will work with Ministers of Health and TDR to assess how to implement this approach in areas that have never used the community-based process before.

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