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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
arts and humanities
Performance of predictors: Evaluating sustainability in community-directed treatment projects of the African programme for onchocerciasis control
Social Science and Medicine, Volume 64, No. 10, Year 2007
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Description
The predictors of sustainability of community-directed treatment with ivermectin (CDTI) at four implementation levels were evaluated in 41 African Programme for Onchocerciasis Control (APOC) projects, encompassing 492 communities in 10 countries. A model protocol provided information on indicators corresponding to nine aspects of a project that is likely to be sustainable at community level after the cessation of external support. Six of the nine aspects had components of community ownership as predictors of project sustainability. Quantitative and qualitative assessments were used to obtain individual community scores and an overall sustainability score for each project graded on a scale of 0-4. Of the 41 projects evaluated, 70% scored "satisfactorily" to "highly sustainable" at the community level. We found variations among countries and that health system weaknesses could hamper community efforts in sustaining a project, such as when ivermectin was delivered late. Community ownership was of primary importance to the community score, and the community-level scores correlated with overall project sustainability. The therapeutic coverage achieved in each project correlated with the ratio of volunteer ivermectin distributors per population served. Surprisingly, the performance of these distributors was not affected by the direct incentives offered, and coverage appeared to be highest when cash or in-kind compensation was not given at all. Although further research is required, anecdotal evidence pointed to diverse indirect benefits for distributors-political goodwill, personal satisfaction and altruistic fulfillment. The results demonstrate that community ownership is among the important determining factors of sustainability of community-based programmes. © 2007 Elsevier Ltd. All rights reserved.
Authors & Co-Authors
Amazigo, Uche
Burkina Faso, Ouagadougou
World Health Organization Ouagadougou
Okeibunor, Joseph Chukwudi
Burkina Faso, Ouagadougou
World Health Organization Ouagadougou
Matovu, Victoria
Burkina Faso, Ouagadougou
World Health Organization Ouagadougou
Zouré, Honorat Gustave Marie
Burkina Faso, Ouagadougou
World Health Organization Ouagadougou
Bump, J.
Burkina Faso, Ouagadougou
World Health Organization Ouagadougou
Sékétéli, Azodoga V.
Burkina Faso, Ouagadougou
World Health Organization Ouagadougou
Statistics
Citations: 89
Authors: 6
Affiliations: 1
Identifiers
Doi:
10.1016/j.socscimed.2007.01.018
ISSN:
02779536
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Approach
Qualitative
Quantitative