title: The Potential for Community-Directed Interventions: Reaching Underserved Populations in Africa.
abstract: Community-directed interventions (CDIs) have the potential for fulfilling the promise of primary health care by reaching underserved populations in various settings. CDI has been successfully tested by expanding access to additional health services like malaria case management through local effort in communities where ivermectin distribution is ongoing. The question remains whether the CDI approach has potential in communities that do not have a foundation of community-directed treatment with ivermectin. The UNICEF/UNDP/World Bank/WHO Special Program of Research and Training in Tropical Diseases commissioned three sets of formative studies to explore the potential for introducing CDI among nomads, urban poor, and rural areas with no community-directed treatment with ivermectin. This article reviews their findings. Community and health system respondents identified a set of mainly communicable diseases that could be adapted to CDI as well as participatory mechanisms like community-based organizations and leaders that could form a foundation for local organizing and participation. It is hoped that the results of these formative studies will spur further research on CDI among peoples with poor health-care access.
authors.affiliation: Department of International Health, Health System Program, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA wbriege1@jhu.edu.
authors.forename: William R
authors.initials: WR
authors.lastname: Brieger
authors.affiliation: UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland.
authors.forename: Johannes U
authors.initials: JU
authors.lastname: Sommerfeld
authors.affiliation: African Program for Onchocerciasis Control, World Health Organization, Ouagadougou, Burkina Faso.
authors.forename: Uche V
authors.initials: UV
authors.lastname: Amazigo
mesh_terms: D000349:Africa; D003153:Community Health Services / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000379:methods*; D005260:Female; D006292:Health Priorities; D006297:Health Services Accessibility; D006801:Humans; D007390:International Agencies; D008297:Male; D008507:Medically Underserved Area; D011204:Poverty Areas; D012424:Rural Population; D014171:Transients and Migrants; D014505:Urban Population; D035862:Vulnerable Populations
keywords: Africa; access; community-directed interventions; infectious diseases prevention and control; nomads; urban and rural health systems