Community Co-Designed Schistosomiasis Control Interventions for School-Aged Children in Zanzibar

Abstract

SummaryTop-down biomedical interventions to control schistosomiasis in sub-Saharan Africa have had limited success, primarily because they fail to engage with the social, political, economic and ecological contexts in which they are delivered. Despite the call to foster community engagement and to adapt interventions to local circumstances, programmes have rarely embraced such an approach. This article outlines a community co-designed process, based upon Human-Centered Design, to demonstrate how this approach works in practice. It is based on initial work undertaken by social science researchers, public health practitioners and community members from the Zanzibar Islands, Tanzania, between November 2011 and December 2013. During the process, 32 community members participated in a qualitative and quantitative data-driven workshop where they interpreted data on local infections from S. haematobium and co-designed interventions with the assistance of a facilitator trained in the social sciences. These interventions included the implementation of novel school-based education and training, the identification of relevant safe play activities and events at local schools, the installation of community-designed urinals for boys and girls and the installation of community-designed laundry-washing platforms to reduce exposure to cercariae-contaminated fresh water. It is suggested that the a community co-designed process, drawing from Human-Centered Design principles and techniques, enables the development of more sustainable and effective interventions for the control of schistosomiasis.

Perceptions about interventions to control schistosomiasis among the Lake Victoria island communities of Koome, Uganda

“…Indeed, health education is important because knowledge about the transmission, severity and consequence of schistosomiasis may be poor [36]. As demonstrated elsewhere, the communities need to be involved in designing the interventions in order to promote ownership of the intervention [24]. …”

“…Therefore, gauging the readiness of communities in schistosomiasis endemic areas for intervention trials is of paramount importance[24]. In this paper, we investigated the perceptions of island communities with a high burden of the disease about their perceptions of schistosomiasis transmission and control.…”

HEALTH EDUCATION AND THE CONTROL OF UROGENITAL SCHISTOSOMIASIS: ASSESSING THE IMPACT OF THEJUMA NA KICHOCHOCOMIC-STRIP MEDICAL BOOKLET IN ZANZIBAR

“…Context-specific and appropriate delivery of health education is an important aspect of any control programme conducted against schistosomiasis (Parker et al, 2008;Aagaard-Hansen et al, 2009;Person et al, 2016). However, it is infrequently evaluated (Engels & Mpitabakana, 1989;Kloos, 1995;Aryeetey et al, 1999;Schall & Diniz, 2001); and measuring the impact of health education can be problematic (Kloos, 1995;Lansdown et al, 2002).…”

Partnering with insiders: A review of peer models across community-engaged research, education and social care

“…Incorporating the voice of community peers is integral to both “good” science and sustainable social change (Rosenthal et al., ; Vaughn et al., ). Traditional research models using a vertical, deficit and “pathogen‐focused” approach have had limited success because they fail to engage the local knowledge, norms and sociocultural, historical, political, economic and ecological contexts of the very people to whom the research, programme or intervention is targeted (Person et al., ). Due to the value placed on insiders’ knowledge, context and experience, we position peer models in two predominant theoretical traditions: (1) human‐centred design (HCD) and (2) action research.…”