Involvement and performance of women in community-directed treatment with ivermectin for onchocerciasis control in Rukungiri District, Uganda.

The present study aimed: (1) to assess and improve the level of women's involvement in a strategy to control onchocerciasis by community-directed treatment with ivermectin (CDTI) in three parishes of Rukungiri District, Uganda; (2) to measure the performance of female community-directed health worke...

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Publicado en:Health & Social Care in the Community Vol. 10; no. 5; pp. 382 - 394
Autores principales: Katabarwa MN, Habomugisha P, Agunyo S
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Sep2002
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2002
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Involvement and performance of women in community-directed treatment with ivermectin for onchocerciasis control in Rukungiri District, Uganda.
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        au:
          Katabarwa MN
          Habomugisha P
          Agunyo S
        affil: Carter Center, Global 2000, PO Box 12027, Kampala, Uganda
      sug:
        subj:
          Nematode Infections Drug Therapy
          Blindness Prevention and Control
          Community Health Services
          Community Health Workers
          Women
          Anthelmintics
          Funding Source
          Uganda
          Sex Factors
          Health Education
          Semi-Structured Interview
          Random Sample
          Cluster Sample
          Confidence Intervals
          Questionnaires
          Participant Observation
          Chi Square Test
          Data Analysis Software
          Decision Making
          Descriptive Statistics
          Male
          Human
          Male
      ab: The present study aimed: (1) to assess and improve the level of women's involvement in a strategy to control onchocerciasis by community-directed treatment with ivermectin (CDTI) in three parishes of Rukungiri District, Uganda; (2) to measure the performance of female community-directed health workers (CDHWs) in comparison with males; and (3) to identify culturally acceptable means of enhancing women's involvement in community-directed healthcare. Health education sessions were used to instruct community members to select female CDHWs in Masya Parish and to stress their potential importance in Karangara Parish; this subject was not raised in Mukono Parish. In all, 403 mature women who were randomly selected from the three parishes were interviewed as to their: (1) knowledge of the classes of people not eligible to take ivermectin; (2) knowledge and beliefs about the benefits of ivermectin; (3) participation in decision-making; and (4) attitudes on the performance of female CDHWs. For analysis, the respondees were divided into: (1) those who had or had not taken ivermectin treatment during the previous year; and (2) those who had or had not attended health education sessions. During the period when face-to-face interviews with women in randomly selected households were being carried out, participatory evaluation meetings (PEMs) were conducted in selected communities from the same parishes in order to reach a consensus on issues which could not easily be included in individual face-to-face interviews. Participant observations were also made regarding: how communities selected their CDHWs; how the CDHWs organised the distribution exercise and treated community members; and how the CDHWs kept records in order to understand issues which were deliberately hidden from the researchers during face-to-face interviews and PEMs. Significantly, the women who had been treated or health educated in Masya Parish were: (1) more knowledgeable on the groups which were not supposed to be treated; (2) aware of women's involvement in mobilisation of other community members; (3) involved in CDTI decision-making; and (4) had a better attitude towards female CDHWs' performance compared with males when compared with those from Karangara and Mukono parishes. There were no differences between the attitude of women in Karangara and Mukono parishes towards performance of female CDHWs. Face-to-face interviews and records from all parishes indicated that female CDHWs achieved as good a coverage as their male counterparts, and sometimes better, in about the same time. Health education increased the number of female CDHWs from nine to 52 in Masya Parish, from 7 to 22 in Karangara Parish and from 6 to 20 in Mukono Parish. Health education improved the attitude of women towards female CDHWs, but the actual experience of having and observing female CDHWs in action in Masya Parish had a more significant positive impact on the womenfolk, as well as on the rest of the community members, and created an impetus for more of them to become actively involved in actual ivermectin distribution. The present authors conclude that recruiting more female CDHWs and supervisors would reduce the current male domination of the health delivery services, greatly strengthening the activities of CDTI programmes.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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