Challenges and opportunities associated with neglected tropical disease and water, sanitation and hygiene intersectoral integration programs
Challenges and opportunities associated with neglected tropical disease and water, sanitation and hygiene intersectoral integration programs
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DOI：
10.1186/s12889-015-1838-7
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发表时间：
2015-06-11
影响因子：
4.5
通讯作者：
Graham, Jay P.
中科院分区：
文献类型：
--
作者：
Johnston, E. Anna;Teague, Jordan;Graham, Jay P.
背景资料：最近的研究表明，除了大规模药物管理（MDA）之外，水、环境卫生和个人卫生（WASH）干预措施对于控制和消除许多被忽视的热带疾病（NTD）也是必要的。目标：这项研究调查了NTD和WASH方案的整合，以确定广泛整合的障碍，并就未来整合的理想条件和最佳做法提出建议。方法：对全球NTD和WASH部门的主要利益相关者进行了24次深入的半结构化访谈，以确定WASH和NTD整合的障碍和理想条件。结果：WASH和NTD整合最常见的障碍包括：1）两个部门的不同项目目标，包括不同的指标和度量标准; 2）对大规模药物管理的过度关注; 3）供资规模的差异; 4）孤立的供资;以及5）两个部门之间缺乏协调和信息共享。与会者还表示，如果要扩大未来的一体化努力，就需要采取更全面的办法。最常提到的必要条件包括：（1）教育和宣传;（2）制定联合指标;（3）增加部长一级的参与;（4）制定综合战略;（5）建立工作队或坚定的伙伴关系;（6）加强捐助者的支持。计划整合NTD和WASH计划的公共卫生从业人员可以应用这些结果为更有效的计划创造条件，并减少成功的障碍。捐助机构应考虑为更多的融合工作提供资金，以进一步检验原则的证明，如果融合工作要取得成功，建议国家和地方政府提供更多的支持。需要作出部门间努力，包括制定共同的指标和目标，以创造有利于扩大有效融合方案的条件。
Background: Recent research has suggested that water, sanitation, and hygiene (WASH) interventions, in addition to mass drug administration (MDA), are necessary for controlling and eliminating many neglected tropical diseases (NTDs).Objectives: This study investigated the integration of NTD and WASH programming in order to identify barriers to widespread integration and make recommendations about ideal conditions and best practices critical to future integrated programs.Methods: Twenty-four in-depth, semi-structured interviews were conducted with key stakeholders in the global NTD and WASH sectors to identify barriers and ideal conditions in programmatic integration.Results: The most frequently mentioned barriers to WASH and NTD integration included: 1) differing programmatic objectives in the two sectors, including different indicators and metrics; 2) a disproportionate focus on mass drug administration; 3) differences in the scale of funding; 4) siloed funding; and 5) a lack of coordination and information sharing between the two sectors. Participants also conveyed that a more holistic approach was needed if future integration efforts are to be scaled-up. The most commonly mentioned requisite conditions included: 1) education and advocacy; 2) development of joint indicators; 3) increased involvement at the ministerial level; 4) integrated strategy development; 5) creating task forces or committed partnerships; and 6) improved donor support.Conclusions: Public health practitioners planning to integrate NTD and WASH programs can apply these results to create conditions for more effective programs and mitigate barriers to success. Donor agencies should consider funding more integration efforts to further test the proof of principle, and additional support from national and local governments is recommended if integration efforts are to succeed. Intersectoral efforts that include the development of shared indicators and objectives are needed to foster conditions conducive to expanding effective integration programs.