An evaluation of the sustainability of river blindness community directed treatment programme in Kisoro District.

Abstract

A study was carried out in Kisoro District to evaluate the sustainability of the River Blindness Program using the APOC parameters of community involvement, treatment coverage, planning and leadership, Health education, Sensitization and Mobilization, Mectizan supply Integration, Finance and funding, Training, and Monitoring and supervision. Data from 10 randomly sampled communities in the district was collected and analyzed retrospectively from the years 2000 to 2005. A total of 100 household heads plus all the CDDs were interviewed face to face on their involvement in the CDTI programme. Also interviewed health workers on their involvement in the CDTI programme; and key district officials on the district’s ability to sustain the programme. The study findings revealed that treatment coverage; the ultimate outcome of all the activities carried out had dropped gradually though there was adequate supply of Mectizan. Community involvement in the programme was very minimal and training had not been carried out for quite some time. Relatedly, the involvement of the district health system in the programme was very minimal and neither had the CDTI program been integrated into the district health system. This study noted that much as it is important to implement community health programmes within the existent community structures they do not ensure continual running of a programme when there are no funds to help oversee implementation at the community level. Further, involvement of the district health team in providing leadership, planning, monitoring and supervision can only be guaranteed if there are specific funds that are identified and put aside for implementation of such programs. Integration of a once parallel program into an existent system may not be as easy as it seems. Integration of activities though time and resource saving can be a challenge if the programs do not have the same implementation strategy and should therefore proceed with caution.