Local tips, global impact: community-driven measures as avenues of promoting inclusion in the control of neglected tropical diseases: a case study in Kenya

Abstract

Background Neglected tropical diseases (NTDs) affect poor populations with little or no ‘political voice’ to influence control activities. While most NTDs have interventions that work, the biggest challenge remains in delivering targeted interventions to affected populations residing in areas experiencing weak health systems. Despite the upward development trends in most countries of sub-Saharan Africa (SSA), the healthcare worker to population ratio remains exceptionally low, with some areas not served at all; thus, there is a need to involve other personnel for school and community-based healthcare approaches. Nonetheless, the current community-based programs suffer from inconsistent community participation due to a lack of coordinated response, and an expanded intervention agenda that lacks context-specific solutions applicable to rural, urban, and marginalized areas. Methods This research investigated the capacity of local communities to address the burden of NTDs. Informed by the social theory of human capability, the research collected primary qualitative data by conducting key informant interviews and focus group discussions of people infected or affected by NTDs. The interview data were collected and transcribed verbatim for thematic analysis using Nvivo version 12. Results Our findings reveal, first, a need for intersectoral collaboration between governments and affected populations for inclusive and sustainable NTD solutions. Second, a ‘bottom-up’ approach that enhances capacity building, sensitization, and behaviour change for improved uptake of NTD interventions. Third, the enforcement of Public Health Legislative Acts that mandates the reporting and treatment of NTDs such as leprosy. Fourth, the establishment of support groups and counseling services to assist persons suffering from debilitating and permanent effects of NTDs. Conclusions Our research demonstrates the importance of human agency in encouraging new forms of participation leading to the co-production of inclusive and sustainable solutions against NTDs.

Exploring the Role of Community Involvement in Reducing the Burden of Schistosomiasis and Other Neglected Tropical Diseases in Malawi: Where are We in the Fight Against Neglected Tropical Diseases?

“…Eliminating high endemic diseases as public health problems requires joint efforts from health program implementers and the community. 31 In most developing countries, disease prevalence and incidence are heightened because of the interplay of economic, social, and biological factors. 49 While most health programs focus on dealing with the biological component of the disease, the social and economic aspects also remain crucial toward mitigating the impact of most NTDs.…”

“…Similarly, a study conducted in Kenya investigating the capacity of local communities to address the burden of NTDs revealed firstly, the need for inter-sectoral collaboration between governments and affected populations for inclusive and sustainable NTD solutions. 31 Secondly, the study recommended the need for a “bottom-up” approach that enhances capacity building, sensitization, and behaviour change for improved uptake of NTD interventions.…”

“…The most significant challenge remains how to deliver interventions to affected populations in areas experiencing weak health systems. 31 For countries such as Malawi, where various health disparities exist when it comes to access to universal health coverage, the community needs to be actively involved in designing most health interventions. The need to engage the community in planning disease control and mitigation measures is becoming more evident now than ever.…”

“…Despite the evident need of supplemental WASH interventions, delivery of appropriate and sustainable interventions, remains a challenge in rural and marginalized settings which experience weak and unstable health systems. 31,32 Studies done across SSA reveal limited knowledge on transmission and control of schistosomiasis in the region, inevitably leading to poor health-seeking behaviours and adoption of interventions. 8,33 Few studies that have investigated community practices on schistosomiasis control and prevention have reported that poor WASH practices were driven by a combination constrained access to WASH services, misconceptions towards schistosomiasis and discrepancy between personal preferences and available interventions.…”

Impact of Poverty on Health

“…• Buruli ulcer • Chagas disease The NTDs are mainly diseases in developing countries, as shown in the maps of some of the NTDs down if compared to the map of poverty shown earlier in the chapter (Figure 6) [77][78][79][80][81][82][83][84]. However, due to a lack of funding, the WHO published a 2021 booklet as a road to end the NTDs by 2030 by integrating their prevention and control (Figure 7) [76].…”