Community-Directed Intervention for Improving Health Care Delivery in Nomadic Populations in Africa: Northeastern Nigeria

Infectious diseases remain a major cause of morbidity and mortality in developing countries. In Africa they are responsible for 60% of all deaths. Effective and simple interventions to prevent or treat such infectious diseases exist but their delivery to affected populations has proven very difficult due to weak health systems in many developing countries.

In some circumstances the current methods of delivery of these interventions are inefficient and unsustainable, thereby limiting their impact. In some cases, treatment of particular infectious diseases does not require trained health professionals and delivery at the community level by community members who have received training has been shown to be successful.

Disease control programmes are therefore increasingly using or opting for these community-based delivery strategies. The Special Programme for Research and Training in Tropical Diseases (TDR) sponsored a major multicountry study to examine the use of a community-directed intervention (CDI)1 strategy to address key health problems. The study showed that the CDI model significantly increased access to antimalarial treatment and preventive tools (bednets) among communities with experience in community-directed distribution of ivermectin.2 Published in 2008, the study generated significant interest among health policy-makers about wider applications of this strategy and, more broadly, applications of community-based interventions (CBIs) 3 in Africa and elsewhere.

The current interest in CBIs thus provides an opportunity for TDR to develop implementation research into efficient and simple community-based strategies for the delivery of health interventions. CBI also builds upon TDR’s considerable research experiences with Home Management of Malaria (HMM) and contributes evidence and strategies to the broader revival of primary health care approaches to health-care delivery. This report sets out the progress made in TDR’s research on Integrated Community-Based Interventions (BL11). The overall goal of the business line is to develop innovative, effective and efficient strategies for implementing CBI in poor populations. It fits into the wider TDR vision “To foster an effective global research effort on infectious diseases of poverty, in which disease endemic countries play a pivotal role”.

Partner/funder: World Health Organization

Source: TDR_BL11.10_eng.pdf (who.int)