An assessment of the sustainability of the onchocerciasis programme in Kanungu District.
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Background: Onchocerciasis in Kanungu District is at meso endemic level. The disease poses significant social and economic challenges to the communities. It afflicts 20% of the district population. Community directed treatment with ivermectin (CDTI) was launched in Kanungu District as a control strategy in 1999. APOC is funding CDTl activities for 5 years after which the country is expected to sustain CDTI activities. Treatment of onchocerciasis requires 15 years. CDTI activities in Kanungu are in the fourth year of APOC funding yet, there is no documented evidence to suggest that the sustainability of CDTl activities in Kanungu is possible. Objectives: The Objective of this study has been to generate evidence-based information that can be used to strengthen and sustain the CDTI activities after APOC support in Kanungu District has ceased. Methodology: This was a descriptive cross sectional study employing qualitative data collection techniques. The respondents were purposively selected at the four levels (National, District, FLHF, community). Respondents were selected from the NOCP office, DDHS office, and the functional heath units. In each first line health unit catchment area, two villages (one with highest therapeutic coverage, one with lowest coverage) were selected. A total of 8 villages were selected for this study. Data Collection on the indicators of sustainability of CDTI involved: use of interviews, documentary reviews; and observations. Results: Key findings revealed that the monitoring and supervision system and the training were most poorly achieved while the leadership, transport, and coverage of the program were the most highly achieved. The program is effective at all levels although its efficiency has been compromised by the inefficient use or resources, the poor monitoring systems and inadequate capacity/empowerment at the district and FLHF levels, Integration of CDTI activities into the existing health services is taking a slow pace There is an over whelming acceptance of the CDTI activities at the community level. Conclusion: The program has a high potential for sustainability.