Characteristics of effective Village Treatment Assistants: the Kongwa Trachoma Project

O'Connor, Janet; Lynch, Matthew; Vitale, Susan; West, Sheila K.

doi:10.1076/opep.6.4.257.4186

Cited by 8 publications

(6 citation statements)

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“…While gender-related differences in terms of NTD burden are well documented, there is a paucity of research on how gender interacts with NTD service provision and uptake. Of the limited literature available, studies have mainly explored access to mass drug administration (MDA) and how gender relates to the experience of being an NTD volunteer [29][30][31][32][33][34][35][36]. For example, that female NTD volunteers uniquely contend with the challenges of balancing work and family commitments [31].…”

Section: Introductionmentioning

confidence: 99%

“…However, a recent study of MDA coverage in 16 countries suggested that NTD programmes "consistently achieve at least equal levels of coverage for women" [30]. Study findings on NTD volunteer performance, specifically, the effectiveness and coverage of MDA by female versus male NTD volunteers and recipient compliance, varied by setting and treatment [31][32][33][34][35][36][37].…”

Section: Introductionmentioning

confidence: 99%

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Gender-related factors affecting health seeking for neglected tropical diseases: findings from a qualitative study in Ethiopia

Wharton-Smith

Rassi

Batisso³

et al. 2019

PLoS Negl Trop Dis

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BackgroundDespite known gender-specific differences in terms of prevalence, transmission and exposure to neglected tropical diseases (NTDs), there is limited discussion of the influence of gender in NTD programmes and interventions. There is a paucity of research on how gender interacts with NTD service provision and uptake. This study, part of broader implementation research in Ethiopia, applied a gender lens to health seeking for five NTDs: lymphatic filariasis, podoconiosis, schistosomiasis, soil-transmitted helminth infection and trachoma. Methodology/principal findingsThe study was conducted in a district of the Southern Nations, Nationalities, and Peoples' Region of Ethiopia where the five NTDs are prevalent. A qualitative methodology was adopted to explore participants' perspectives and experiences. Data generation methods included 20 interviews and four focus group discussions. Community members, volunteer Health Development Army leaders, Health Extension Workers and a range of health workers at the health post, health centre and hospital level (n = 59) were purposively sampled. Interviews and focus group discussions were audio recorded, transcribed verbatim into English then analysed through open coding, drawing on constant comparative methods.Gender related factors affected care seeking for NTDs and were described as reasons for not seeking care, delayed care seeking and treating NTDs with natural remedies. Women faced additional challenges in seeking health care due to gender inequalities and power dynamics in their domestic partnerships. Participants recommended raising community awareness about NTDs, however this remains problematic due to gender and social norms around appropriate discourse with members of the opposite gender.PLOS Neglected Tropical Diseases | https://doi. Funding:The study was co-funded by COMDIS-HSD (comdis-hsd.leeds.ac.uk), a research consortium funded by UK aid from the UK government (www.gov.uk/government/ organisations/department-for-internationaldevelopment). The views expressed in this manuscript do not necessarily reflect the funder's Conclusions/significanceThe findings from this study provide crucial insights into how gender interacts with accessing health services, at different levels of the health system. If we are committed to leaving no one behind and achieving universal health coverage, it is essential to address gender disparities to access and utilisation of interventions delivered by national NTD programmes. Author summaryThis study provides insights into how gender influences peoples' access to health services for neglected tropical diseases (NTDs). There is considerable evidence to show that women and girls suffer a greater NTD burden due to their higher levels of poverty, lower education and social status. The psychological and social consequences of NTDs also tend to be worse for women. There is an urgent need to integrate NTDs into basic healthcare services, yet there is little evidence that can support a gender-based approach of how best to do so. This study...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Gender-related factors affecting health seeking for neglected tropical diseases: findings from a qualitative study in Ethiopia

Wharton-Smith

Rassi

Batisso³

et al. 2019

PLoS Negl Trop Dis

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“…Janet O'Connor et al in Tanzania have evidence to suggest that Village Treatment Assistants (with a similar background to LHWs in Pakistan) are effective in treating communities with tetracycline eye ointment, particularly for trachoma. 11 The possible association of literacy with prevalence of NVIC was also studied ( Table 5). Although the association may be presumptive, as the variables were few and there may be other factors like population density, climate and season during which the study was conducted, it was evident that 48% of the study population that had had no schooling suffered from NVIC, while those that had received some form of schooling had NVIC in 22% to 33% of the sample.…”

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confidence: 99%

Prevalence of non-vision-impairing conditions in a village in Chakwal district, Punjab, Pakistan

Hussain¹,

Awan²,

Khan

2004

Ophthalmic Epidemiology

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“…As members of the community, CTAs also possess a deep understanding of the local culture and language, which can be beneficial, particularly when cases are to be referred for surgery. Additionally, charging local leadership with the task of determining recruitment criteria and selection of their own CTAs, as has been implemented in Kongwa, promotes a sense of community buy-in and partial ownership of the trachoma and trichiasis control efforts [ 26 ]. Such community-based approaches to disease detection and control also allow for the integration of trichiasis screening into other existing programs.…”

Section: Discussionmentioning

confidence: 99%

Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania

Greene

West

Mkocha³

et al. 2015

PLoS Negl Trop Dis

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BackgroundSimple surgical intervention advocated by the World Health Organization can alleviate trachomatous trichiasis (TT) and prevent subsequent blindness. A large backlog of TT cases remain unidentified and untreated. To increase identification and referral of TT cases, a novel approach using standard screening questions, a card, and simple training for Community Treatment Assistants (CTAs) to use during Mass Drug Administration (MDA) was developed and evaluated in Kongwa District, a trachoma-endemic area of central Tanzania.Methodology/Principal FindingsA community randomized trial was conducted in 36 communities during MDA. CTAs in intervention villages received an additional half-day of training and a TT screening card in addition to the training received by CTAs in villages assigned to usual care. All MDA participants 15 years and older were screened for TT, and senior TT graders confirmed case status by evaluating all screened-positive cases. A random sample of those screened negative for TT and those who did not present at MDA were also evaluated by the master graders. Intervention CTAs identified 5.6 times as many cases (n = 50) as those assigned to usual care (n = 9, p < 0.05). While specificity was above 90% for both groups, the sensitivity for the novel screening tool was 31.2% compared to 5.6% for the usual care group (p < 0.05).Conclusions/SignificanceCTAs appear to be viable resources for the identification of TT cases. Additional training and use of a TT screening card significantly increased the ability of CTAs to recognize and refer TT cases during MDA; however, further efforts are needed to improve case detection and reduce the number of false positive cases.

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Characteristics of effective Village Treatment Assistants: the Kongwa Trachoma Project

Cited by 8 publications

References 10 publications

Gender-related factors affecting health seeking for neglected tropical diseases: findings from a qualitative study in Ethiopia

Gender-related factors affecting health seeking for neglected tropical diseases: findings from a qualitative study in Ethiopia

Prevalence of non-vision-impairing conditions in a village in Chakwal district, Punjab, Pakistan

Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania

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