Community dialogues for prevention and control of neglected tropical diseases

PROJECT BRIEF

The project aims to assess the effectiveness of the community dialogues approach in enhancing community participation and improving knowledge and practices for the prevention and control of neglected tropical diseases (NTDs) at the community level

Project outline
The 17 NTDs prioritised by the World Health Organization comprise diseases caused by a variety of parasitic pathogens, including lymphatic filariasis, onchocerciasis, schistosomiasis, soil transmitted helminthiases and trachoma. They have been grouped together as ‘neglected diseases’ as they have traditionally received less attention and funding than other diseases like malaria and HIV/AIDS, and because they disproportionally affect poor and marginalised people in remote areas of low-income and fragile countries.

Many NTDs can be prevented and controlled through preventive chemotherapy, which is commonly provided to target populations through integrated mass drug administration (MDA) – the administration of drugs to entire populations irrespective of disease status. To maximise populations’ protection from NTDs, preventive chemotherapy needs to be complemented by effective case management, vector control and the adoption of basic
sanitation and hygiene practices.

As MDA is typically administered to at-risk populations over a period of several years, community perceptions, experiences and understanding of both NTDs and MDA are likely to have a significant effect on coverage rates. Community perceptions will also influence how widely prevention mechanisms such as hand washing are adopted among populations living in endemic areas. In this context, studies suggest that NTD control programmes could be improved by paying closer attention to social mobilisation and community involvement.

This study will use the community dialogues approach, which has previously been used by Malaria Consortium in the context of integrated community case management, to improve communities’ knowledge and practices with regard to NTDs. The project will focus on schistosomiasis, a parasitic infection that is acquired when people come into contact with freshwater infested with the larval forms of the parasite, which is highly endemic in Mozambique.

The community dialogues approach builds on existing community-based structures and aims to enable communities to make informed choices and to take individual and collective action through providing a simple and flexible model and easy-to-use tools. The process involves trained facilitators from within the community hosting regular community dialogues sessions to explore relevant health topics, identify issues and plan for specific actions.

Community dialogues will be implemented in all communities in four districts of Nampula province in northern Mozambique: Mecubúri, Eráti, Morrupula and Mogovolas. Prevalence rates of schistosomiasis in the province are estimated to be as high as 78 percent.

To allow for a comparison of the community dialogues approach in different country contexts, it is anticipated that Malaria Consortium will link with the Centre for Global Health Research in Kumasi, Ghana, a partner on the COMDIS-HSD Research Programme Consortium. The exact scope of the Ghana arm of the study is yet to be determined.

Project objectives
The main objectives of the study are to:
» Develop, adapt and implement the community dialogues approach for use in an NTD context
» Assess whether the community dialogues approach contributes towards enhancing communities’ understanding and knowledge of prevention and control of NTDs, especially of MDA
» Assess whether the community dialogues approach contributes towards increasing community participation in healthcare delivery related to NTD prevention and control
» Engage with national and international stakeholders to develop services and interventions that will improve prevention and control of NTDs
» Contribute to the literature on communities’ perceptions of NTDs and MDA and the effectiveness of community participation approaches.