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The impact of integrating the elimination programme for lymphatic filariasis into primary health care in the Dominican Republic.
Baker, Margaret C; McFarland, Deborah A; Gonzales, Manuel; Diaz, Mary Janet; Molyneux, David H.
Afiliação
  • Baker MC; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, UK. Margaret.fraser@liv.ac.uk
Int J Health Plann Manage ; 22(4): 337-52, 2007.
Article em En | MEDLINE | ID: mdl-17729213
Integration of disease-specific programmes into existing health care delivery systems is a challenge for many countries, made more salient as the scope and scale of disease-specific programmes increases. This paper reports on the programmatic outcomes of 2 years of integrating the lymphatic filariasis (LF) elimination programme into primary health care (PHC) in the Dominican Republic during a period of national health care reform and decentralization. Data were collected retrospectively from community volunteers, PHC staff and LF programme staff using a mix of quantitative and qualitative methods. Benefits of integration for LF elimination included increasing the extent of the geographic coverage of mass drug administration (MDA) and a 21% increase in municipalities achieving the MDA target coverage rate of 80%. Benefits which accrued to PHC included improved information systems and strengthened relationships between the health services and the community. This study also identified challenges to implementing integration and the solutions found. These include the importance of focusing on the professional development of disease-specific program staff as their roles change, strengthening specific weakness in the general health system and finding alternative solutions where these are not easily solved, actively engaging senior management at an early stage, continually evaluating the impact of integration and not pushing integration for the sake of integration.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Filariose Linfática Tipo de estudo: Evaluation_studies / Observational_studies / Prognostic_studies / Qualitative_research Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: Caribe ingles / Dominica / Republica dominicana Idioma: En Revista: Int J Health Plann Manage Assunto da revista: PESQUISA EM SERVICOS DE SAUDE / SERVICOS DE SAUDE Ano de publicação: 2007 Tipo de documento: Article País de publicação: Reino Unido
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Filariose Linfática Tipo de estudo: Evaluation_studies / Observational_studies / Prognostic_studies / Qualitative_research Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: Caribe ingles / Dominica / Republica dominicana Idioma: En Revista: Int J Health Plann Manage Assunto da revista: PESQUISA EM SERVICOS DE SAUDE / SERVICOS DE SAUDE Ano de publicação: 2007 Tipo de documento: Article País de publicação: Reino Unido