This study aimed to establish the role of social mobilization in mass drug administration (MDA) u... more This study aimed to establish the role of social mobilization in mass drug administration (MDA) uptake during the National Programme to Eliminate Lymphatic Filariasis (LF) in Kenya. MDA for LF based on diethylcarbamazine (DEC) and albendazole using community-based treatment approach has been conducted for three years (2003, 2005 and 2008) in Kwale and Malindi districts. In each district, one high and one low, compliance locations were selected based on 2008 MDA data. From the four locations, nine villages were systematically sampled and a total of 965 randomly selected household heads interviewed. Sixteen focus group discussions with adult and youth male and female groups and separate in-depth interviews with eighty opinion leaders and eighty LF patients with clinical manifestations, purposively selected were conducted. Semi-structured interviews were held separately with fifteen community drug distributors, five health personnel and four LF coordinators also purposively selected. T...
Supplemental material, VAW886380_Supplemental_Material_CLN for Empirical Insights for Improving S... more Supplemental material, VAW886380_Supplemental_Material_CLN for Empirical Insights for Improving Sexual Assault Prevention: Evidence From Baseline Data for a Cluster-Randomized Trial of IMPower and Sources of Strength by Evan Rosenman, Clea Sarnquist, Rina Friedberg, Mary Amuyunzu-Nyamongo, Gabriel Oguda, Dorothy Otieno and Michael Baiocchi in Violence Against Women
Draft versionThis paper considers gender a key determinant of women’s health in agro-ecosystems, ... more Draft versionThis paper considers gender a key determinant of women’s health in agro-ecosystems, as distinct from other factors such as race and ethnicity. Global trade provisions, advancement in technology and access to extension services influence the health outcomes of women and their households. Since women’s family obligations traditionally include provision of food and caring for children, they are granted access to land, but not ownership; nor are they enabled to make decisions on the disposal of land or to have access to micro-finance. The gender gap imposes real costs to society in terms of lost agricultural output, food security and economic growth
Summary Community engagement is crucial for controlling disease outbreak and mitigating natural a... more Summary Community engagement is crucial for controlling disease outbreak and mitigating natural and industrial disasters. The COVID-19 pandemic has reconfirmed the need to elevate community engagement to build equity, trust and sustained action in future health promotion preparedness strategies. Using the health promotion strategy of strengthening community action enhances the opportunity for better outcomes. There is, therefore, a need to improve our understanding of community engagement practices during crises, scale-up good community engagement initiatives, and improve and sustain people-centered approaches to emergency responses. This paper presents five case studies from the United States, Singapore, Sierra Leone, Kenya and South Africa that demonstrate the potential strengths that can be nurtured to build resilience in local communities to help mitigate the impact of disasters and emergencies. The case studies highlight the importance of co-developing relevant education and co...
The Cervical Cancer Prevention Program in Zambia (CCPPZ) has increasingly used community-level st... more The Cervical Cancer Prevention Program in Zambia (CCPPZ) has increasingly used community-level structures to increase the uptake and ensure the sustainability of the program. Traditional marriage counselors, the alangizi, who have existed in the Zambian society for many years, are one of the structures used by the program to impart cervical cancer knowledge and increase access to screening and care using an existing community structure. Several steps were followed in developing this intervention: (a) ensuring the alangizi understood the process of screening by encouraging them to go through the screening process; (b) workshops were arranged for the alangizi to meet and share experiences during which lessons were given on cervical cancer by health workers as well; and (c) eight alangizi were chosen to help document the lessons as part of ensuring that cervical cancer information is accurate and passed in a consistent manner. Over 70 alangizi, who had undergone cervical cancer screeni...
CNCD-Africa was established in July 2009 in response to and in recognition of the continuously in... more CNCD-Africa was established in July 2009 in response to and in recognition of the continuously increasing burden of diseases such as injuries, non-communicable diseases (NCDs) and mental health in low- and middle-income countries, and specifically in countries of sub-Saharan Africa. CNCD-Africa aims to comprehensively address specific and common objectives while building capacity in the region to prevent and control NCDs. With support from key partners and funders, and a keen interest in opportunities to address NCDs from health promotion and equity perspectives, the Consortium has excelled in four key areas: convening; knowledge generation and sharing; advocacy; and networking. However, the path to successful and sustainable efforts remains laden with challenges and barriers. Retaining interest of network partners through flagship efforts and continued efforts to ascertain support from local and international partners with interest in NCDs across the region remain essential to CNCD...
Annals of Tropical Medicine and Public Health, 2012
Background: Annual Mass Drug Administration (MDA) to at least 65 - 80% of the population at risk ... more Background: Annual Mass Drug Administration (MDA) to at least 65 - 80% of the population at risk is necessary for Lymphatic Filariasis (LF) elimination. In Kenya, MDA based on diethylcarbamazine and albendazole, using the community-directed treatment (ComDT) approach has been implemented thrice in the Kwale and Malindi districts. To identify the socioeconomic factors influencing compliance with MDA, a retrospective cross-sectional study was conducted in the two districts after the 2008 MDA. Materials and Methods: In Kwale, the Tsimba location was selected for high and Gadini for low coverage, while in Malindi, the Goshi location represented high and Gongoni, low coverage. Using systematic sampling, nine villages were selected from the four locations. Quantitative data was collected from 965 systematically selected household heads and analyzed using SPSS v. 15. For qualitative data, which was analyzed manually according to core themes of the study, 80 opinion leaders and 80 LF patients with clinical signs were purposively selected and interviewed, and 16 focus group discussions (FGDs) conducted with adult and youth male and female groups. Results: Christians were slightly more (49.1%) in the high compliance areas compared to Muslims (34.3%), while Muslims prevailed (40.6%) in the low compliance areas compared to Christians (29%). On the income level, 27% from the low compared to 12.2% from the high compliance areas had a main occupation, indicative of a higher income, and 95% from the low compared to 78% from high compliance areas owned land, also an indicator of higher economic status. Accurate knowledge of the cause of swollen limbs was higher (37%) in the high compared to 25.8% in the low compliance areas, and so was accurate knowledge about the cause of swollen genitals (26.8% in high compared to 14% in low). Risk perception was higher in the high compliance areas (52% compared to 45%) and access to MDA information seemed to have been better in the high compared to low compliance areas. Patients from the high compliance areas had a higher mean number of years with chronic disease (15.2 compared to 9.7). Conclusions: There is a need for more investment in reaching out to groups that are often missed during MDAs. Different strategies have to be devised to reach those in specific religious groupings and those in casual employment. This could include prolonging the duration of MDA to capture those who are out during the week seeking for casual and other forms of employment.
Volunteer community drug distributors (CDDs) have been vital to progress made in the elimination ... more Volunteer community drug distributors (CDDs) have been vital to progress made in the elimination of onchocerciasis and lymphatic filariasis; two neglected tropical diseases amenable to preventive chemotherapy (PC-NTDs). However, formative work in Côte d’Ivoire and Uganda revealed that CDDs can encounter considerable challenges during mass drug administration (MDA). CDDs must be resilient to overcome these challenges, yet little is known about their resilience. This mixed-methods study explored the resilience of CDDs in Côte d’Ivoire and Uganda. The characteristics and experiences of 248 CDDs involved in the 2018 MDAs in Côte d’Ivoire (N = 132) and Uganda (N = 116) were assessed using a micronarrative survey. Thematic analysis of CDDs’ micronarratives was used to identify challenges they encountered during MDA. Resilience was assessed using the Connor-Davidson Resilience Scale 25 (CD-RISC-25). Variables from the micronarrative survey found to be individually associated with mean CD-R...
This study aimed to establish the role of social mobilization in mass drug administration (MDA) u... more This study aimed to establish the role of social mobilization in mass drug administration (MDA) uptake during the National Programme to Eliminate Lymphatic Filariasis (LF) in Kenya. MDA for LF based on diethylcarbamazine (DEC) and albendazole using community-based treatment approach has been conducted for three years (2003, 2005 and 2008) in Kwale and Malindi districts. In each district, one high and one low, compliance locations were selected based on 2008 MDA data. From the four locations, nine villages were systematically sampled and a total of 965 randomly selected household heads interviewed. Sixteen focus group discussions with adult and youth male and female groups and separate in-depth interviews with eighty opinion leaders and eighty LF patients with clinical manifestations, purposively selected were conducted. Semi-structured interviews were held separately with fifteen community drug distributors, five health personnel and four LF coordinators also purposively selected. T...
Supplemental material, VAW886380_Supplemental_Material_CLN for Empirical Insights for Improving S... more Supplemental material, VAW886380_Supplemental_Material_CLN for Empirical Insights for Improving Sexual Assault Prevention: Evidence From Baseline Data for a Cluster-Randomized Trial of IMPower and Sources of Strength by Evan Rosenman, Clea Sarnquist, Rina Friedberg, Mary Amuyunzu-Nyamongo, Gabriel Oguda, Dorothy Otieno and Michael Baiocchi in Violence Against Women
Draft versionThis paper considers gender a key determinant of women’s health in agro-ecosystems, ... more Draft versionThis paper considers gender a key determinant of women’s health in agro-ecosystems, as distinct from other factors such as race and ethnicity. Global trade provisions, advancement in technology and access to extension services influence the health outcomes of women and their households. Since women’s family obligations traditionally include provision of food and caring for children, they are granted access to land, but not ownership; nor are they enabled to make decisions on the disposal of land or to have access to micro-finance. The gender gap imposes real costs to society in terms of lost agricultural output, food security and economic growth
Summary Community engagement is crucial for controlling disease outbreak and mitigating natural a... more Summary Community engagement is crucial for controlling disease outbreak and mitigating natural and industrial disasters. The COVID-19 pandemic has reconfirmed the need to elevate community engagement to build equity, trust and sustained action in future health promotion preparedness strategies. Using the health promotion strategy of strengthening community action enhances the opportunity for better outcomes. There is, therefore, a need to improve our understanding of community engagement practices during crises, scale-up good community engagement initiatives, and improve and sustain people-centered approaches to emergency responses. This paper presents five case studies from the United States, Singapore, Sierra Leone, Kenya and South Africa that demonstrate the potential strengths that can be nurtured to build resilience in local communities to help mitigate the impact of disasters and emergencies. The case studies highlight the importance of co-developing relevant education and co...
The Cervical Cancer Prevention Program in Zambia (CCPPZ) has increasingly used community-level st... more The Cervical Cancer Prevention Program in Zambia (CCPPZ) has increasingly used community-level structures to increase the uptake and ensure the sustainability of the program. Traditional marriage counselors, the alangizi, who have existed in the Zambian society for many years, are one of the structures used by the program to impart cervical cancer knowledge and increase access to screening and care using an existing community structure. Several steps were followed in developing this intervention: (a) ensuring the alangizi understood the process of screening by encouraging them to go through the screening process; (b) workshops were arranged for the alangizi to meet and share experiences during which lessons were given on cervical cancer by health workers as well; and (c) eight alangizi were chosen to help document the lessons as part of ensuring that cervical cancer information is accurate and passed in a consistent manner. Over 70 alangizi, who had undergone cervical cancer screeni...
CNCD-Africa was established in July 2009 in response to and in recognition of the continuously in... more CNCD-Africa was established in July 2009 in response to and in recognition of the continuously increasing burden of diseases such as injuries, non-communicable diseases (NCDs) and mental health in low- and middle-income countries, and specifically in countries of sub-Saharan Africa. CNCD-Africa aims to comprehensively address specific and common objectives while building capacity in the region to prevent and control NCDs. With support from key partners and funders, and a keen interest in opportunities to address NCDs from health promotion and equity perspectives, the Consortium has excelled in four key areas: convening; knowledge generation and sharing; advocacy; and networking. However, the path to successful and sustainable efforts remains laden with challenges and barriers. Retaining interest of network partners through flagship efforts and continued efforts to ascertain support from local and international partners with interest in NCDs across the region remain essential to CNCD...
Annals of Tropical Medicine and Public Health, 2012
Background: Annual Mass Drug Administration (MDA) to at least 65 - 80% of the population at risk ... more Background: Annual Mass Drug Administration (MDA) to at least 65 - 80% of the population at risk is necessary for Lymphatic Filariasis (LF) elimination. In Kenya, MDA based on diethylcarbamazine and albendazole, using the community-directed treatment (ComDT) approach has been implemented thrice in the Kwale and Malindi districts. To identify the socioeconomic factors influencing compliance with MDA, a retrospective cross-sectional study was conducted in the two districts after the 2008 MDA. Materials and Methods: In Kwale, the Tsimba location was selected for high and Gadini for low coverage, while in Malindi, the Goshi location represented high and Gongoni, low coverage. Using systematic sampling, nine villages were selected from the four locations. Quantitative data was collected from 965 systematically selected household heads and analyzed using SPSS v. 15. For qualitative data, which was analyzed manually according to core themes of the study, 80 opinion leaders and 80 LF patients with clinical signs were purposively selected and interviewed, and 16 focus group discussions (FGDs) conducted with adult and youth male and female groups. Results: Christians were slightly more (49.1%) in the high compliance areas compared to Muslims (34.3%), while Muslims prevailed (40.6%) in the low compliance areas compared to Christians (29%). On the income level, 27% from the low compared to 12.2% from the high compliance areas had a main occupation, indicative of a higher income, and 95% from the low compared to 78% from high compliance areas owned land, also an indicator of higher economic status. Accurate knowledge of the cause of swollen limbs was higher (37%) in the high compared to 25.8% in the low compliance areas, and so was accurate knowledge about the cause of swollen genitals (26.8% in high compared to 14% in low). Risk perception was higher in the high compliance areas (52% compared to 45%) and access to MDA information seemed to have been better in the high compared to low compliance areas. Patients from the high compliance areas had a higher mean number of years with chronic disease (15.2 compared to 9.7). Conclusions: There is a need for more investment in reaching out to groups that are often missed during MDAs. Different strategies have to be devised to reach those in specific religious groupings and those in casual employment. This could include prolonging the duration of MDA to capture those who are out during the week seeking for casual and other forms of employment.
Volunteer community drug distributors (CDDs) have been vital to progress made in the elimination ... more Volunteer community drug distributors (CDDs) have been vital to progress made in the elimination of onchocerciasis and lymphatic filariasis; two neglected tropical diseases amenable to preventive chemotherapy (PC-NTDs). However, formative work in Côte d’Ivoire and Uganda revealed that CDDs can encounter considerable challenges during mass drug administration (MDA). CDDs must be resilient to overcome these challenges, yet little is known about their resilience. This mixed-methods study explored the resilience of CDDs in Côte d’Ivoire and Uganda. The characteristics and experiences of 248 CDDs involved in the 2018 MDAs in Côte d’Ivoire (N = 132) and Uganda (N = 116) were assessed using a micronarrative survey. Thematic analysis of CDDs’ micronarratives was used to identify challenges they encountered during MDA. Resilience was assessed using the Connor-Davidson Resilience Scale 25 (CD-RISC-25). Variables from the micronarrative survey found to be individually associated with mean CD-R...
Jones C.M., McQueen D.V. & Amyunzu-Nyamongo, M. (2009) The global context for health promotion de... more Jones C.M., McQueen D.V. & Amyunzu-Nyamongo, M. (2009) The global context for health promotion development: cultivating effective implementation in Africa through the GPHPE. In Amyunzu-Nyamongo M. & Nyamwaya D.O. (eds.) Evidence of Health Promotion Effectiveness in Africa. Nairobi: African Institute for Health Development; 3-11.
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