Involvement Of Community-based Organizations Research Articles

Effect of community-based intervention on awareness of dengue and its prevention among urban poor community in India: a systematic review approach

Owing to increased epidemic activity and difficulties in controlling the insect vector, dengue has become a major public health problem globally. The prevention and control of dengue rely mainly on vector control methods. A systematic review was conducted using four databases (PubMed, Cochrane, Google Scholar and Scopus) and a manual search of the reference lists of the identified studies. Data from included studies were extracted, analyzed. Applying all inclusion and exclusion criteria 23 articles was included. Further relevant articles using this keywords Aedes dengue breeding habits housing and community intervention were selected. Eight studies combined community participation programme with dengue control tools. Findings of the published literature indicate that at baseline, almost half the respondents did not know that dengue is serious but preventable, or that it is transmitted by mosquitoes. The analysis showed that dengue vector control is carried out by vertically structured programmes of national, state, and local administrative bodies through fogging and larval control, without any involvement of community-based organizations, and that vector control efforts were conducted in an isolated and irregular way. The most productive container types for Aedes pupae were cement tanks, drums, and discarded containers. Evidence that community-based dengue control programmes alone and in combination with other control activities can enhance the effectiveness of dengue control programmes is weak. This review demonstrates a paucity of reliable evidence for the effectiveness of any dengue vector control method. Standardized studies of higher quality to evaluate and compare methods must be prioritized to optimize cost-effective dengue prevention. Clear best practice guidelines for the methodology of entomological studies should be developed.

Community response to the Ebola outbreak: Contribution of community-based organisations and community leaders in four health districts in Guinea

ABSTRACT The major challenges in controlling the Ebola Virus Disease (EVD) outbreak in Guinea were contact tracing, referral of suspected cases, secure burial and mistrust in the context of a weak health system. Community involvement and uptake of key interventions were very low, contributing to the spread of the epidemic. A community engagement project, using community based organisations (CBOs) and community leaders, was implemented in four affected health districts in rural Guinea. This paper reports on the contribution of the CBOs and community leaders in controlling the EVD outbreak. Base-, mid- and end – line assessments were conducted using a mixed methods approach. In total, 422 CBOs members, 50 community leaders and 40 village birth attendants were engaged in social mobilisation, awareness raising, reaching 154,310 people and leading to the end of reluctance and mistrust. Thus, 95 suspected cases were referred to health facilities, contact tracing and secure burial increased from 88.0% to 96.6% and from 67% to 95.4%, respectively, and institutional deliveries increased from 637 to 806. Involvement of CBOs and community leaders against the EVD outbreak is an effective resource that should also be considered to better respond to possible large-scale epidemic threats in a fragile health system context.

Enabling Integrated Health and Care

Enabling Integrated Health and Care

Enhancing HIV Testing and Treatment among Men Who Have Sex with Men in China: A Pilot Model with Two-Rapid Tests, Single Blood Draw Session, and Intensified Case Management in Six Cities in 2013.

ObjectivesTo explore models to improve HIV testing, linkage to care and treatment among men who have sex with men (MSM) in cooperation with community-based organizations (CBOs) in China.MethodsWe introduced a new model for HIV testing services targeting MSM in six cities in 2013.These models introduced provision of rapid HIV testing by CBO staff and streamlined processes for HIV screening, confirmation of initial reactive screening results, and linkage to care among diagnosed people. We monitored attrition along each step of the continuum of care from screening to treatment and compared program performance between 2012 and 2013. According to the providers of two rapid tests (HIV screening), four different services delivery models were examined in 2013: Model A = first screen at CDC, second at CDC (Model A = CDC+CDC), Model B = first and second screens at CBOs (Model B = CBO+CBO), Model C = first screen at CBO, second at Hospital (Model C = CBO+Hosp), and Model D = first screen at CBO, second at CDC (Model D = CBO+CDC). Logistic regressions were performed to assess advantages of different screening models of case finding and case management.ResultsCompared to 2012, the number of HIV screening tests performed for MSM increased 35.8% in 2013 (72,577 in 2013 vs. 53,455 in 2012). We observed a 5.6% increase in proportion of cases screened reactive receiving HIV confirmatory tests (93.9% in 2013 vs. 89.2% in 2012, χ2 = 48.52, p<0.001) and 65% reduction in loss to CD4 cell count tests (15% in 2013 vs. 43% in 2012, χ2 = 628.85, p<0.001). Regarding linkage to care and treatment, the 2013 pilot showed that the Model D had the highest rate of loss between screening reactive and confirmatory test among the four models, with 18.1% fewer receiving a second screening test and a further 5.9% loss among those receiving HIV confirmatory tests. The Model B and the Model C showed lower losses (0.8% and 1.3%) for newly diagnosed HIV positives receiving CD4 cell count tests, and higher rates of HIV positives referred to designated ART hospitals (88.0% and 93.3%) than the Model A and Model D (4.6% and 5.7% for CD4 cell count test, and 68.9% and 64.4% for referring to designated ART hospitals). The proportion of cases where the screening test was reactive that were commenced on ART was highest in Model C; 52.8% of cases commenced on ART compared to 38.9%, 34.2% and 21.1% in Models A, B and D respectively. Using Model A as a reference group, the multivariate logistic regression results also showed the advantages of Models B, C and D, which increased CD4 cell count test, referral to designated ART hospitals and initiation of ART, when controlling for program city and other factors.ConclusionsThis study has demonstrated that involvement of CBOs in HIV rapid testing provision, streamlining testing and care procedures and early hospital case management can improve testing, linkage to, and retention in care and treatment among MSM in China.

Community-based control of Aedes aegypti by adoption of eco-health methods in Chennai City, India

Background: Dengue is highly endemic in Chennai city, South India, in spite of continuous vector control efforts. This intervention study was aimed at establishing the efficacy as well as the favouring and limiting factors relating to a community-based environmental intervention package to control the dengue vector Aedes aegypti.Methods: A cluster randomized controlled trial was designed to measure the outcome of a new vector control package and process analysis; different data collection tools were used to determine the performance. Ten randomly selected intervention clusters (neighbourhoods with 100 houses each) were paired with ten control clusters on the basis of ecological/entomological indices and sociological parameters collected during baseline studies. In the intervention clusters, Aedes control was carried out using a community-based environmental management approach like provision of water container covers through community actors, clean-up campaigns, and dissemination of dengue information through schoolchildren. The main outcome measure was reduction in pupal indices (pupae per person index), used as a proxy measure of adult vectors, in the intervention clusters compared to the control clusters.Results: At baseline, almost half the respondents did not know that dengue is serious but preventable, or that it is transmitted by mosquitoes. The stakeholder analysis showed that dengue vector control is carried out by vertically structured programmes of national, state, and local administrative bodies through fogging and larval control with temephos, without any involvement of community-based organizations, and that vector control efforts were conducted in an isolated and irregular way. The most productive container types for Aedes pupae were cement tanks, drums, and discarded containers. All ten intervention clusters with a total of 1000 houses and 4639 inhabitants received the intervention while the ten control clusters with a total of 1000 houses and 4439 inhabitants received only the routine government services and some of the information education and communication project materials. The follow-up studies showed that there was a substantial increase in dengue understanding in the intervention group with only minor knowledge changes in the control group. Community involvement and the partnership among stakeholders (particularly women’s self-help groups) worked well. After 10 months of intervention, the pupae per person index was significantly reduced to 0·004 pupae per person from 1·075 (P = 0·020) in the intervention clusters compared to control clusters. There were also significant reductions in the Stegomyia indices: the house index was reduced to 4·2%, the container index to 1·05%, and the Breteau index to 4·3 from the baseline values of 19·6, 8·91, and 30·8 in the intervention arm.Conclusion: A community-based approach together with other stakeholders that promoted interventions to prevent dengue vector breeding led to a substantial reduction in dengue vector density.

Role of NGOs, CBOs and Private Organizations for Efficient Management of Municipal Solid Waste in Kathmandu Valley

This paper attempts to discuss the role of Community based, nongovernmental and private institutions for the management of municipal solid waste in Kathmandu Valley. It is based on secondary information available from different sources. Studies reveal that private institutions, Community Based Organizations (CBOs) and Non Governmental Organizations are collecting about 60% of the total waste generated within Kathmandu Valley from door-to-door of the generators. These institutions are also contributing to reduce about 40% of the municipal cost for the collection of waste. Study reveals that household segregation and compositing is considered as the best option for the efficient management of municipal solid waste in the cities of developing countries like Kathmandu. This is possible only through the involvement of CBOs, NGOs and private sector.

The Interdependence of Immunization Registries and Community Outreach Programs

Immunization registries provide opportunities to target education and outreach programs to children most in need. Outreach programs are designed to get underimmunized children into primary care settings for their immunizations to be brought up-to-date. Meanwhile, registries generate the data for proactive and reactive outreach: sending reminder cards to each child as a dose of vaccine comes due, and/or contacting the family when the child has missed a dose. As registries’ developmental phases have an impact on community-based programs, refinements of outreach programs should therefore reflect the development of the immunization registries. Our objective is to demonstrate the need to integrate developing immunization registries and outreach programs. The progress of four All Kids Count programs (Philadelphia, PA; Richmond, VA; Nashville, TN; and Milwaukee, WI) was reviewed. The following aspects of each program were examined: the development of the registries, including methods of populating the data base and securing immunization-event data; community outreach design; the involvement of community-based organizations (CBOs); and the effect of regulations/legislation related to sharing of immunization data. Immunization registries and community outreach programs work together in a feedback loop. The quality of information in the registry directly affects the quality of the outreach efforts. Properly designed outreach programs can help improve the accuracy of registry data. The ability of programs to raise immunization levels is dependent on the development of effective immunization registries and of effective outreach efforts. The interdependence of immunization registries and community outreach programs necessarily implies that as the registries become more and more complete the outreach programs will become more and more effective. The interdependence of immunization registry development and community outreach design must be acknowledged in order to maximize the effectiveness of both efforts.