Transcript Document

Figure 3. Spectrum of activities leading to CDTI
Treatment strategy
Decision
making
Pure mobile
team
approach
Outreach
using mobile
team
OCP informs
chief
OCP-team
based in a
hospital and
“fans out” to
villages
Process
Delivery to
village
Record
keeping
Chronology
Description
NGO / nurse
informs chief
Community
based
treatment
Community
based
treatment
Community
based
treatment
National
program
Nurses
(Volunteers for
absentees)
Volunteers
selected by
the Chief
Volunteers
(CBD)
CBD
OCP
Nurse / CHW
CHW
CBD
CBD
District
NGO / District
1989
used by the
(OCP) from
1989 (when the
drug became
available
through the
Mectizan
Donation
Programme)
1990
Used by OCP
and some
NGOs when
they started
treating with
ivermectin
Nurse on a
motor bike or
mobylette went
to villages from
a Health centre
District
1991
Volunteer
carried out the
treatments but
timing of
treatment, drug
delivery to
village decided
by the
program, and
volunteer
chosen by chief
or program
CDD
Community
consulted about
when to
distribute the
drugs
mixed
District
1995
1997
Community
asked to
decide when
and how to do
the drug
distribution and
to choose the
CBD
Community
chose CDD,
timing and
method of
treatment,
records kept by
CDD and CDD
goes to pick up
drugs from
health centre .
Involvment & ownership by community
External
direction
Community
Directed
Treatment
CDD
(from health center)
CHW / CBD
Nurses
OCP
Community
Directed
treatment
Community
Nurses / CHW
Distribution
Supervision
NGO
supported
Outreach
Community
directed
ownership shift through CDTI
CDTI: Community Directed Treatment with Ivermectin | OCP: Onchocerciasis Control Programme | CBD: Community Based Distributor | CHW: Community Health worker
Community
chose CDD,
timing and
method of
treatment,
records kept by
CDD and CDD
goes to pick up
drugs from
health centre