Topics: CHW role, Community health workers, Community involvement, Directly observed treatment, DOTS, Home-based management of malaria, Infectious diseases, Insecticide-treated nets (ITNs), Malaria, Program design, Scaling up, Tuberculosis

Region and Country: Africa, Sub Saharan

In 2005, a three-year multi-country study was launched to examine how the Community Directed Intervention (CDI) approach, which had been remarkably successful in distributing ivermectin for treatment of onchocerciasis, could be used alongside ivermectin for integrated delivery (or co-implementation) of four other health interventions: Vitamin A supplementation, distribution of insecticide-treated nets, directly observed treatment, short course (DOTS) for tuberculosis and home-management of malaria. The study covered a total of 2.35 million people. This publication describes the results from seven research sites in Cameroon, Nigeria and Uganda. The CDI approach was shown to be much more effective than currently-used delivery approaches for all studied interventions except DOTs. CDI was also more cost-efficient than conventional delivery methods. Based on the study results, the authors recommend that, in areas with experience in community-directed treatment for onchocerciasis control, the CDI approach should be used for integrated, community level delivery of a broader range of appropriate health interventions.