Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study
Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study
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DOI：
10.1186/2049-9957-2-25
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发表时间：
2013-01-01
影响因子：
8.1
通讯作者：
Sommerfeld, Johannes
中科院分区：
文献类型：
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作者：
Ajayi, Ikeoluwapo O.;Jegede, Ayodele S.;Sommerfeld, Johannes
背景资料：许多简单、负担得起和有效的疾病控制措施由于难以获得，特别是较贫穷人口（城市和农村）难以获得，以及社区参与不足，影响有限。社区指导干预（CDI）方法是解决获得健康干预问题的一项行之有效的策略，该方法已在农村地区成功使用。本研究进行了评估资源使用的CDI战略在提供卫生干预措施服务差的城市社区在伊巴丹，尼日利亚。方法：一个形成性的研究进行了8个城市贫困社区在伊巴丹大都会在奥约州。定性方法包括与社区成员的12次焦点小组讨论（FGD）和与社区领导人，项目经理，社区组织（CBO），非政府组织（NGO）和联邦，州和地方政府层面的其他利益相关者的73次关键知情人访谈（KII），用于收集数据以确定流行疾病和医疗保健服务，以及探索CDI战略的潜在资源。所有访谈都有录音。结果：疟疾、上呼吸道感染、腹泻和麻疹是儿童的主要疾病，高血压和糖尿病是成人的主要疾病。医疗保健的资金主要来自自付费用。费用和地点被确定为利用保健设施的障碍;非正式合作社（esusu）可用于支持那些无法支付保健费用的人。免疫、营养、生殖健康、结核病和麻风病、环境卫生、疟疾和艾滋病毒/艾滋病控制方案是正在进行的干预措施。提供战略包括逐户、家庭治疗、健康教育和宣传运动。据报告，社区参与发展项目的规划、执行和监测是一种常见做法。可用于这些活动的资源包括社区志愿人员、社区组织和非政府组织，它们是土发委会进程的潜在资源。其他人是房东;专业，妇女和青年协会;社会俱乐部，宗教组织和可用的卫生facility.Conclusion：这项研究的结果支持的可行性，使用CDI过程中提供健康干预措施，在城市贫困社区，并显示，该战略的潜在资源丰富的社区。
Background: Many simple, affordable and effective disease control measures have had limited impact due to poor access especially by the poorer populations (urban and rural) and inadequate community participation. A proven strategy to address the problem of access to health interventions is the Community Directed Interventions (CDI) approach, which has been used successfully in rural areas. This study was carried out to assess resources for the use of a CDI strategy in delivering health interventions in poorly-served urban communities in Ibadan, Nigeria.Methods: A formative study was carried out in eight urban poor communities in the Ibadan metropolis in the Oyo State. Qualitative methods comprising 12 focus group discussions (FGDs) with community members and 73 key informant interviews (KIIs) with community leaders, programme managers, community-based organisations (CBOs), non-government organisations (NGOs) and other stakeholders at federal, state and local government levels were used to collect data to determine prevalent diseases and healthcare delivery services, as well as to explore the potential resources for a CDI strategy. All interviews were audio recorded. Content analysis was used to analyse the data.Results: Malaria, upper respiratory tract infection, diarrhoea and measles were found to be prevalent in children, while hypertension and diabetes topped the list of diseases among adults. Healthcare was financed mainly by out-of-pocket expenses. Cost and location were identified as hindrances to utilisation of health facilities; informal cooperatives (esusu) were available to support those who could not pay for care. Immunisation, nutrition, reproductive health, tuberculosis (TB) and leprosy, environmental health, malaria and HIV/AIDs control programmes were the ongoing interventions. Delivery strategies included house-to-house, home-based treatment, health education and campaigns. Community participation in the planning, implementation and monitoring of development projects was reported as common practice. The resources available for these activities and which constitute potential resources for the CDI process include community volunteers, CBOs and NGOs. Others are landlords; professional, women and youth associations; social clubs, religious organisations and the available health facilities.Conclusion: This study's findings support the feasibility of using the CDI process in delivering health interventions in urban poor communities and show that potential resources for the strategy abound in the communities.