Community-directed treatment is a relatively new strategy that was adopted in 1997 by the African Programme for @entity7289 Control (APOC), for large-scale distribution of ivermectin (Mectizan). Participatory monitoring of 39 of the control projects based on community-directed treatment with ivermectin (CDTI) was undertaken from 1998-2000, with a focus on process implementation of the strategy and the predictors of sustainability. Data from 14,925 household interviews in 2314 villages, 183 complete treatment records, 382 focus-group discussions, and the results of interviews with 669 community leaders, 757 trained @entity497 ( @entity497 ) and 146 health personnel (in 26 projects in four countries) were analysed. The data show that @entity497 dispensed ivermectin to 65.4% of the total population (71.2% of the eligible population), with no significant gender differences in coverage (P > 0.05). Treatment coverage ranged from 60.2% of the eligible subjects in Cameroon to 76.9% in Uganda. There was no significant relationship between the provision of incentives to @entity497 and treatment coverage (P > 0.05). The frequency of treatment refusal was highest in Cameroon (29.2%). Although most (72.1%) of the communities investigated selected their @entity497 on the basis of a community decision at a village meeting, only 37.9% chose their distribution period in the same way. There is clearly a need to improve communication strategies, to address the issues of absentees and refusals, to emphasise community ownership and to de-emphasise incentives for @entity497 . The investigation of the 'predictor indicators' of sustainability should enable APOC to understand the determinants of project performance and to initiate any appropriate changes in the programme.

Monitoring community-directed treatment programmes for sustainability: lessons from the African Programme for XXXX Control (APOC).

@entity497 :: ('MESH:D003147', 'Disease') :: ['CDD', 'community-directed drug distributors'] @entity7289 :: ('MESH:D009855', 'Disease') :: ['Onchocerciasis']
@entity7289 :: (MESH:D009855,Disease) :: ['Onchocerciasis']
