Healing starts at home

Community-administered healthcare is incredibly effective in combating a range of illnesses, including river blindness and malaria, as well as micronutrient deficiencies, according to a study of more than two-million people in three African countries.

Now researchers say restrictive Health Department policies on who can administer medicines should be dropped so that other illnesses can be tackled in a similar fashion.

Community-directed drug intervention has proved successful in delivering the drug Ivermectin to treat river blindness, caused by a parasite transmitted by a fly bite. In the strategy family members help deliver drugs and administer treatment instead of patients visiting a clinic — which often doesn’t exist or doesn’t function.

The study looked at the effectiveness of community-run medical help to fight river blindness in West Africa, later pairing it with treatments for malaria, tuberculosis and micronutrient deficiencies. The research was done in Cameroon, Nigeria and Uganda.

Community dispensing of drugs, vitamin A supplements and insecticide-treated mosquito nets was compared with conventional clinic-based professional efforts over three years.

Researchers found that the number of feverish children receiving the right antimalarial treatment doubled, exceeding the 60% target set by the Roll Back Malaria campaign. The use of insecticide-treated bednets to prevent malaria also doubled.

Vitamin A supplementation cove-rage was significantly higher in districts that use community volunteers than in those that do not. Even community-directed interventions for tuberculosis – which require a daily course of anti-microbial drugs over half a year — proved to be as effective as treatment from clinics. TB treatment was the only example where the community was not better than the clinic.

Samuel Wanji, a researcher at the University of Buéa who conducted the south-west Cameroon part of the study, said the African Programme for Onchocerciasis (river blindness) Control — linked to the World Health Organisation (WHO) and with 19 health ministers on the board — has given the go-ahead to extend the use of community-directed intervention for river blindness in countries that don’t have crisis levels of the disease but are still affected.

The expanded programme will investigate whether neighbours, parents and friends work as well in places where disease infection is less intense and is scheduled to begin before the end of the year. Other medications will be added as the programme progresses.

”The study’s approach is very useful for increasing access to treatment and will reduce the burden on health facilities,” said Hans Remme of the WHO Special Programme for Research and Training in Tropical Disease in Switzerland.

But a shortage of drugs and other materials remains a drawback, according to a WHO report of the study. —

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