Community-directed distributors-The "foot soldiers" in the fight to control and eliminate neglected tropical diseases.
PLoS Negl Trop Dis
; 15(3): e0009088, 2021 03.
Article
in English
| MEDLINE | ID: covidwho-1117468
ABSTRACT
The neglected tropical diseases (NTDs) affect hundreds of millions of people, predominantly in rural, often difficult-to-access areas, poorly served by national health services. Here, we review the contributions of 4.8 million community-directed distributors (CDDs) of medicines over 2 decades in 146,000 communities in 27 sub-Saharan African countries to control or eliminate onchocerciasis and lymphatic filariasis (LF). We examine their role in the control of other NTDs, malaria, HIV/AIDS interventions, immunisation campaigns, and support to overstretched health service personnel. We are of the opinion that CDDs as community selected, trained, and experienced "foot soldiers," some of whom were involved in the Ebola outbreak responses at the community level in Liberia, if retrained, can assist community leaders and support health workers (HWs) in the ongoing Coronavirus Disease 2019 (COVID-19) crisis. The review highlights the improved treatment coverage where there are women CDDs, the benefits and lessons from the work of CDDs, their long-term engagement, and the challenges they face in healthcare delivery. It underscores the value of utilising the CDD model for strong community engagement and recommends the model, with some review, to hasten the achievement of the NTD 2030 goal and assist the health system cope with evolving epidemics and other challenges. We propose that, based on the unprecedented progress made in the control of NTDs directly linked to community engagement and contributions of CDDs "foot soldiers," they deserve regional and global recognition. We also suggest that the World Health Organization (WHO) and other international stakeholders promote policy and guidance for countries to adapt this model for the elimination of NTDs and to strengthen national health services. This will enhance the accomplishment of some Sustainable Development Goals (SDGs) by 2030 in sub-Saharan Africa.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Onchocerciasis
/
Elephantiasis, Filarial
/
Community Health Services
/
Neglected Diseases
/
Mass Drug Administration
Limits:
Female
/
Humans
Country/Region as subject:
Africa
Language:
English
Journal:
PLoS Negl Trop Dis
Journal subject:
Tropical Medicine
Year:
2021
Document Type:
Article
Affiliation country:
Journal.pntd.0009088
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