The role of community participation for sustainable integrated neglected tropical diseases and water, sanitation and hygiene intervention programs: A pilot project in Tanzania
The role of community participation for sustainable integrated neglected tropical diseases and water, sanitation and hygiene intervention programs: A pilot project in Tanzania
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DOI：
10.1016/j.socscimed.2018.02.016
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发表时间：
2018-04-01
影响因子：
5.4
通讯作者：
Michael, Edwin
中科院分区：
文献类型：
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作者：
Madon, Shirin;Malecela, Mwele Ntuli;Michael, Edwin
旨在减少坦桑尼亚被忽视的热带病流行率的战略，包括那些归因于水、环境卫生和个人卫生问题的战略，基本上是自上而下的。他们的重点是通过整合不同的垂直疾病方案和提高报告生成效率，加强NTD-WASH方案的治理。在本文中，我们认为，社区参与作为一个有效的战略，发展可持续的村庄健康治理。我们介绍了2015年11月至2016年4月期间开展的试点项目的结果，在该项目中，我们采用了混合方法案例研究方法，利用现有的村庄治理结构实施增强型发展治理（EDG）模型。我们的研究结果表明，EDG模型与血吸虫病和腹泻的患病率在统计上显着减少，并导致提高认识的WASH干预措施，以维持收益在NTD控制。我们确定了EDG模型制定的五个关键社会过程，这些过程导致了与会议和出席频率相关的健康福利的改善，促进健康和卫生意识，创收活动，自我组织能力以及村庄机构之间的互动。这些研究结果具有重要的意义，概念化的作用，社区参与持续NTD-WASH干预方案和敏感的体制和政策改革。
Strategies aimed at reducing the prevalence of neglected tropical diseases (NTDs) in Tanzania including those attributed to water, sanitation and hygiene (WASH) problems have been largely top-down in nature. They have focused on strengthening the governance of NTD-WASH programs by integrating different vertical disease programs and improving the efficiency of report-generation. In this paper, we argue for community participation as an effective strategy for developing sustainable village health governance. We present the results of a pilot undertaken between November 2015 and April 2016 in which we adopted a mixed methods case study approach to implement an Enhanced Development Governance (EDG) model using existing village governance structures. Our results show that the EDG model was associated with a statistically significant reduction in the prevalence of schistosomiasis and diarrhoea, and has led to an increase in awareness of WASH interventions for sustaining gains in NTD control. We identify five key social processes enacted by the EDG model that have led to improved health benefits related to frequency of meetings and attendance, promotion of health and sanitation awareness, income-generating activities, self-organising capabilities, and interaction between village bodies. These findings hold important implications for conceptualising the role of community participation in sustaining NTD-WASH intervention programs and for sensitising institutional and policy reform.