Community-directed interventions for priority health problems in Africa: results of a multicountry study
The community-directed intervention (CDI) strategy is an approach in which communities themselves direct the planning and implementation of intervention delivery. Adopted by the African Programme for Onchocerciasis Control (APOC) in the mid-1990s, the CDI strategy has helped to ensure and sustain the delivery of annual ivermectin treatment to over 75 million Africans, many living in remote areas.
The success of the CDI strategy in onchocerciasis control has sparked widespread interest in applying the strategy and using the established community network for other interventions. A multicountry study was launched in 2005 to determine the extent to which the CDI approach could effectively and efficiently provide integrated delivery of other health interventions of varying complexity. These included delivery of insecticide-treated bed nets, detection and treatment of TB, home management of malaria, and Vitamin A supplementation. The present article provides a synthesis of the main findings of the study.
Bulletin of the World Health Organization (2010) 88: 509-518. [doi: 10.2471/BLT.09.069203]