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Community-directed interventions strategy enhances efficient and effective integration of health care delivery and development activities in rural disadvantaged communities of Uganda

Tropical Medicine & International Health
Volume 10 Issue 4 Page 312 - April 2005

M. N. Katabarwa, P. Habomugisha, F. O. Richards Jr and D. Hopkins
The Carter Center, Atlanta GA, USA

Summary: The community-directed interventions (CDI) strategy achieved a desired coverage of the ultimate treatment goal (UTG) of at least 90% with ivermectin distribution for onchocerciasis control, and filled the gap between the health care services and the communities. However, it was not clear how its primary actors the community-directed health workers (CDHW) and community-directed health supervisors (CDHS) would perform if they were given more responsibilities for other health and development activities within their communities. A total of 429 of 636 (67.5%) of the CDHWs who were involved in other health and development activities performed better than those who were involved only in ivermectin distribution, with a drop-out rate of 2.3%. A total of 467 of 864 (54.1%) of CDHSs who were involved in other health and development activities also maintained the desired level of performance. They facilitated updating of household registers (P < 0.05), trained and supervised CDHWs, and educated community members about onchocerciasis control (P < 0.001). Their drop-out rate was 2.6%. The study showed that the majority of those who dropped out had not been selected by their community members. Therefore, CDI strategy promoted integration of health and development activities with a high potential for sustainability.

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This is an electronic version of an article published in Tropical Medicine and International Health: complete citation information for the final version of the paper, as published in the print edition of Tropical Medicine and International Health, is available on the Blackwell Synergy online delivery service, accessible via the journal's website at or

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