Dr. Kate York returned to Tanzania in June to disseminate the results of research conducted in 2011 in collaboration with the development organization Sightsavers International, the Tanzania Ministry of Health and Social Welfare (Neglected Tropical Disease Division), the Morogoro Regional Health Authority, Ifakara Health Institute, and the villages of Kizinga and Tandai in the Morogoro Rural District. The purpose of the research was to explore factors affecting community members’ participation in the medication distribution program for onchocerciasis (river blindness) and to determine the role and influence of the community health workers in the program.
Onchocerciasis is a parasitic disease that causes intense itching, skin changes and disfigurement, and low vision or blindness. Treatment with ivermectin, an antiparasitic agent, is needed once a year for 15 years in order to fully treat the disease. The Community-Directed Treatment with Ivermectin (CDTI) program features a yearly campaign to treat villagers by going house-to-house to distribute the drug. The populations in over 5000 villages in Tanzania are at risk for contracting onchocerciasis, which is a major public health threat to people who are also at risk for other tropical diseases, including malaria.
As the World Bank funding for this program is set to end in 2015, ways to incorporate the program into the existing health system and sustain treatment rates are necessary to continue the benefits to the communities. Community health workers are a likely bridge between the community-based treatment program and the health system. Increasing their participation in the program could lead to a sustainable program over time and retention of the physical, psychological, and socioeconomic benefits of disease eradication.
The return to Tanzania was a great success. Several recommendations for improving participation and incorporating community health workers in the program were implemented after the preliminary report was given to the Ministry of Health last year, and more changes are on the way after this visit. During the dissemination meetings, the leaders of the participating villages provided excellent suggestions to improve the success of the program, which will be incorporated into the recommendations. Priorities for future research were discussed with all collaborators and will soon be finalized. Let the grant writing begin!