02672nas a2200421   4500000000100000008004100001653001100042653003100053653002600084653002300110653001900133653000900152653001500161653002800176653001100204653002100215653001100236653002700247653002800274653002000302653003000322653002500352653001000377100001600387700001800403700001300421700001600434700001300450700001500463700001400478700001100492700001600503245013800519300001100657490000800668520156000676022001402236       2010                            d10aUganda10aSurveys and Questionnaires10aRural Health Services10aProgram evaluation10aonchocerciasis10aMale10aIvermectin10aInterpersonal Relations10aHumans10aHealth Education10aFemale10aFamily Characteristics10aDelivery of Health Care10aDecision Making10aCommunity Health Services10aAntiparasitic Agents10aAdult1 aKatabarwa M1 aHabomugisha P1 aAgunyo S1 aMcKelvey AC1 aOgweng N1 aKwebiiha S1 aByenume F1 aMale B1 aMcFarland D00aTraditional kinship system enhanced classic community-directed treatment with ivermectin (CDTI) for onchocerciasis control in Uganda.  a265-720 v1043 a<p>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&lt;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.</p>

<p>&nbsp;
<p>&nbsp;
<p>&nbsp;</p>
</p>
</p>
  a1878-3503