02561nas a2200277   4500000000100000008004100001260003400042653001800076653003400094653003000128653004300158653002700201100001200228700001400240700001500254700001600269700001300285700001400298700002000312700001600332700001400348245017600362856004800538520168300586022001402269       2021                            d  bMaad Rayan Publishing Company10aHealth Policy10aHealth Information Management10aLeadership and Management10aManagement, Monitoring, Policy and Law10aHealth(social science)1 aZulu JM1 aMaritim P1 aSilumbwe A1 aHalwiindi H1 aMubita P1 aSichone G1 aMpandamabula CH1 aShamilimo F1 aMichelo C00aUnlocking Trust in Community Health Systems: Lessons from the Lymphatic Filariasis Morbidity Management and Disability Prevention Pilot Project in Luangwa District, Zambia  uhttps://www.ijhpm.com/jufile?ar_sfile=547243 a<jats:p>Background: Surgery for hydrocele is commonly promoted as part of morbidity management and disability prevention (MMDP) services for lymphatic filariasis (LF). However, uptake of these surgeries has been suboptimal owing to several community level barriers that have triggered mistrust in such services. This study aimed at documenting mechanisms of unlocking trust in community health systems (CHS) in the context of a LF hydrocele management project that was implemented in Luangwa District, Zambia. Methods: Qualitative data was collected through in-depth interviews and focus group discussions (n=45) in February 2020 in Luangwa District. Thirty-one in-depth interviews were conducted with hydrocele patients, CHWs, health workers, traditional leaders and traditional healers. Two focus group discussions were also conducted with CHWs who had been involved in project implementation with seven participants per group. Data was analyzed using a thematic analysis approach. Results: The use of locally appropriate communication strategies, development of community driven referral systems, working with credible community intermediaries as well as strengthening health systems capacity through providing technical and logistical support enhanced trust in surgery for hydrocele and uptake of the surgeries. Conclusion: Implementation of community led communication and referral systems as well as strengthening health services are vital in unlocking trust in health systems as such mechanisms trigger authentic partnerships, including mutual respect and recognition in the CHS. The mechanisms also enhance confidence in health services among community members.</jats:p>  a2322-5939