Neglected tropical disease (NTD) control in health systems: The interface between programmes and general health services

Marchal, Bruno; Dormael, Monique Van; Pirard, Marjan; Cavalli, Anna; Kegels, Guy; Polman, Katja

doi:10.1016/j.actatropica.2011.02.017

Cited by 61 publications

(60 citation statements)

References 62 publications

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“…This situation reflects what Biesma and colleagues [8] have called ‘ missed opportunities ’, or opportunities not seized that can produce positive synergies between disease control programmes and the general health system [42,43]. These synergies are pre-requisites for attaining programme objectives and health system goals [44,45], and achieving long-term outcomes [41,44]. Therefore, a routine monitoring of the interface by managers of general health services and of programmes will provide avenues for optimizing the interaction between programmes and general health services by proactively searching and seizing all opportunities [46].…”

Section: Discussionmentioning

confidence: 84%

The interface between the national tuberculosis control programme and district hospitals in Cameroon: missed opportunities for strengthening the local health system –a multiple case study

et al. 2013

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BackgroundTuberculosis remains a major public health problem in sub-Saharan Africa. District hospitals (DHs) play a central role in district-based health systems, and their relation with vertical programmes is very important. Studies on the impact of vertical programmes on DHs are rare. This study aims to fill this gap. Its purpose is to analyse the interaction between the National Tuberculosis Control Programme (NTCP) and DHs in Cameroon, especially its effects on the human resources, routine health information system (HIS) and technical capacity at the hospital level.MethodsWe used a multiple case study methodology. From the Adamaoua Region, we selected two DHs, one public and one faith-based. We collected qualitative and quantitative data through document reviews, semi-structured interviews with district and regional staff, and observations in the two DHs.ResultsThe NTCP trained and supervised staff, designed and provided tuberculosis data collection and reporting tools, and provided anti-tuberculosis drugs, reagents and microscopes to DHs. However, these interventions were limited to the hospital units designated as Tuberculosis Diagnostic and Treatment Centres and to staff dedicated to tuberculosis control activities. The NTCP installed a parallel HIS that bypassed the District Health Services. The DH that performs well in terms of general hospital care and that is well managed was successful in tuberculosis control. Based on the available resources, the two hospitals adapt the organisation of tuberculosis control to their settings. The management teams in charge of the District Health Services are not involved in tuberculosis control. In our study, we identified several opportunities to strengthen the local health system that have been missed by the NTCP and the health system managers.ConclusionWell-managed DHs perform better in terms of tuberculosis control than DHs that are not well managed. The analysis of the effects of the NTCP on the human resources, HIS and technical capacity of DHs indicates that the NTCP supports, rather than strengthens, the local health system. Moreover, there is potential for this support to be enhanced. Positive synergies between the NTCP and district health systems can be achieved if opportunities to strengthen the district health system are seized. The question remains, however, of why managers do not take advantage of the opportunities to strengthen the health system.

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Section: Discussionmentioning

confidence: 84%

The interface between the national tuberculosis control programme and district hospitals in Cameroon: missed opportunities for strengthening the local health system –a multiple case study

et al. 2013

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“…However, the importance of integration of NTD control into broad health systems is now being recognized [81], [82]. Moreover, technical guidelines by the WHO Regional Office for Africa (AFRO) and Member States were recently released for the Integrated Disease Surveillance and Response (IDSR) strategy [83].…”

Section: Ways Forwardmentioning

confidence: 99%

“…Efforts to provide greater availability of basic medical supplies to rural health care settings in central Africa would help minimize the risk of large outbreaks of EHF and MHF, as well as have the broad benefit of preventing non-related health care–associated infections in patients and health care workers, and ensure greater patient safety. A recent report by Marchal et al stressed potential linkages between NTD control and improvement of health systems [82]. While infection control during medical care is only one aspect of the entire health system, renewed focus on improving health systems may have a direct impact on prevention of initial spread, and ultimately outbreaks, of EHF and MHF.…”

Section: Ways Forwardmentioning

confidence: 99%

Ebola and Marburg Hemorrhagic Fevers: Neglected Tropical Diseases?

MacNeil

Rollin²

2012

PLoS Negl Trop Dis

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Ebola hemorrhagic fever (EHF) and Marburg hemorrhagic fever (MHF) are rare viral diseases, endemic to central Africa. The overall burden of EHF and MHF is small in comparison to the more common protozoan, helminth, and bacterial diseases typically referred to as neglected tropical diseases (NTDs). However, EHF and MHF outbreaks typically occur in resource-limited settings, and many aspects of these outbreaks are a direct consequence of impoverished conditions. We will discuss aspects of EHF and MHF disease, in comparison to the “classic” NTDs, and examine potential ways forward in the prevention and control of EHF and MHF in sub-Saharan Africa, as well as examine the potential for application of novel vaccines or antiviral drugs for prevention or control of EHF and MHF among populations at highest risk for disease.

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“…Such findings have led to regular calls for a more integrated approach to implementing communicable disease programs 4 , 8 – 13 …”

Section: Introductionmentioning

confidence: 99%

Meningococcal vaccine introduction in Mali through mass campaigns and its impact on the health system

Mounier-Jack

Burchett

Griffiths

et al. 2014

Glob Health Sci Pract

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Neglected tropical disease (NTD) control in health systems: The interface between programmes and general health services

Cited by 61 publications

References 62 publications

The interface between the national tuberculosis control programme and district hospitals in Cameroon: missed opportunities for strengthening the local health system –a multiple case study

The interface between the national tuberculosis control programme and district hospitals in Cameroon: missed opportunities for strengthening the local health system –a multiple case study

Ebola and Marburg Hemorrhagic Fevers: Neglected Tropical Diseases?

Meningococcal vaccine introduction in Mali through mass campaigns and its impact on the health system

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