Use of an inclusive-partnership strategy in urban areas of Orissa, India, to increase compliance in a mass drug administration for the control of lymphatic filariasis

Abstract

In India, the programme to eliminate lymphatic filariasis, which is largely based on mass administrations of diethylcarbamazine, has, in terms of coverage and compliance, been generally much less successful in urban areas than in rural communities. An innovative strategy to make the programme more effective in urban settings, largely based on an inclusive partnership and community participation, has recently been developed. An evaluation of the strategy's implementation in Orissa, which employed both quantitative and qualitative methods of data collection, revealed significantly higher coverage and compliance in an urban area where the strategy had been implemented than in a similar urban area where there had been no such intervention. Application of this strategy in other urban settings in general, and in small towns in particular, is recommended in India.

The architecture and effect of participation: a systematic review of community participation for communicable disease control and elimination. Implications for malaria elimination

“…Factors such remoteness, poor weather, availability of transport and inadequate road infrastructure can hamper implementation of prevention and control activities, supervision of health workers or volunteers and reduce the availability of vital health promotion and preventative and curative services [57,62,71,72,92]. In concurrence with findings related to stigma, social mechanisms and power relationships; socio-cultural accessibility was also identified as having an important impact on participation [36,60,74,85,90]. …”

“…The dynamic social tissue within urban centres and between urban and rural areas created by economically stimulated rapid urban growth, increased population mobility and community heterogeneity and complicates efforts in achieving participation of urban communities [64,65,90,101]. In addition, urban communities are likely to rely more heavily on the private sector for their health needs than rural communities, and hence public sector health programmes can be less successful in engaging this population [90].…”

“…The dynamic social tissue within urban centres and between urban and rural areas created by economically stimulated rapid urban growth, increased population mobility and community heterogeneity and complicates efforts in achieving participation of urban communities [64,65,90,101]. In addition, urban communities are likely to rely more heavily on the private sector for their health needs than rural communities, and hence public sector health programmes can be less successful in engaging this population [90]. Strategies used to increase community participation in urban areas have therefore included; collaboration with the formal private sector; intensive profiling of urban communities prior to engagement activities to ensure representation of all stakeholder groups (including ethnic minorities, students and prisoners); the development of an urban area specific strategy for community participation; and capitalising on social linkages across urban and rural communities [55,65,90].…”

Improving drug delivery strategies for lymphatic filariasis elimination in urban areas in Ghana

“…The nature, composition and dynamics of urban populations may require that MDA activities are tailored to particular groups [11,15]. The use of education materials should focus on the local environment, health system, social structure, culture, population density and method of drug distribution [21].…”

“…An adequate level of 65% epidemiologic coverage is needed to eliminate LF [8], but this continues to remain a challenge in urban areas for most countries including Ghana. While there is little literature available on urban MDA [9–11], the scarcity of information makes it even more difficult to solve the challenges presented. The Greater Accra Region (GAR) with Accra as the capital city of Ghana continues to get low coverage for its annual MDA.…”