Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study

Infectious Diseases of Poverty

Johannes Sommerfeld³  Catherine O Falade²  Ayodele S Jegede⁴  Ikeoluwapo O Ajayi¹ 

[1] Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria;Department of Pharmacology and Therapeutics, College of Medicine, University of Medicine, University of Ibadan, Ibadan, Nigeria;Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland;Department of Sociology, The Faculty of Social Sciences, University of Ibadan, Ibadan, Nigeria

关键词: Community participation;    Health interventions;    Urban poor;    Community directed intervention;   

Others  :  802733
DOI  :  10.1186/2049-9957-2-25

 received in 2013-07-08, accepted in 2013-10-18,  发布年份 2013

【 摘 要 】

Background

Many simple, affordable and effective disease control measures have had limited impact due to poor access especially by the poorer populations (urban and rural) and inadequate community participation. A proven strategy to address the problem of access to health interventions is the Community Directed Interventions (CDI) approach, which has been used successfully in rural areas. This study was carried out to assess resources for the use of a CDI strategy in delivering health interventions in poorly-served urban communities in Ibadan, Nigeria.

Methods

A formative study was carried out in eight urban poor communities in the Ibadan metropolis in the Oyo State. Qualitative methods comprising 12 focus group discussions (FGDs) with community members and 73 key informant interviews (KIIs) with community leaders, programme managers, community-based organisations (CBOs), non-government organisations (NGOs) and other stakeholders at federal, state and local government levels were used to collect data to determine prevalent diseases and healthcare delivery services, as well as to explore the potential resources for a CDI strategy. All interviews were audio recorded. Content analysis was used to analyse the data.

Results

Malaria, upper respiratory tract infection, diarrhoea and measles were found to be prevalent in children, while hypertension and diabetes topped the list of diseases among adults. Healthcare was financed mainly by out-of-pocket expenses. Cost and location were identified as hindrances to utilisation of health facilities; informal cooperatives (esusu) were available to support those who could not pay for care. Immunisation, nutrition, reproductive health, tuberculosis (TB) and leprosy, environmental health, malaria and HIV/AIDs control programmes were the ongoing interventions. Delivery strategies included house-to-house, home-based treatment, health education and campaigns. Community participation in the planning, implementation and monitoring of development projects was reported as common practice. The resources available for these activities and which constitute potential resources for the CDI process include community volunteers, CBOs and NGOs. Others are landlords; professional, women and youth associations; social clubs, religious organisations and the available health facilities.

Conclusion

This study’s findings support the feasibility of using the CDI process in delivering health interventions in urban poor communities and show that potential resources for the strategy abound in the communities.

【 授权许可】

   
2013 Ajayi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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