دورية أكاديمية
Neglected Tropical Diseases as a 'litmus test' for Universal Health Coverage? Understanding who is left behind and why in Mass Drug Administration: Lessons from four country contexts.
| العنوان: | Neglected Tropical Diseases as a 'litmus test' for Universal Health Coverage? Understanding who is left behind and why in Mass Drug Administration: Lessons from four country contexts. |
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| المؤلفون: | Dean L; Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom., Ozano K; Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom., Adekeye O; Sightsavers, Nigeria Country Office, Kaduna State, Nigeria., Dixon R; Sightsavers, Research Team, Haywards Heath, United Kingdom., Fung EG; COUNTDOWN, Research Foundation for Tropical Diseases and Environment, Buea, Cameroon.; COUNTDOWN, Department of Sociology and Anthropology, Faculty of Social and Management Sciences, University of Buea, Buea, Cameroon., Gyapong M; Institute of Health Research, University of Allied Sciences, Ho, Volta Region, Ghana., Isiyaku S; Sightsavers, Nigeria Country Office, Kaduna State, Nigeria., Kollie K; Neglected Tropical Disease Programme, Ministry of Health, Government of Liberia, Monrovia, Monsterrado, Liberia., Kukula V; Social Science Department, Dodowa Health Research Centre, Ghana Health Services, Dodowa, Ghana., Lar L; Sightsavers, Nigeria Country Office, Kaduna State, Nigeria., MacPherson E; Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom., Makia C; Catholic University of Central Africa, Yaoundé, Cameroon., Kouokam Magne E; Catholic University of Central Africa, Yaoundé, Cameroon., Nnamdi DB; COUNTDOWN, Research Foundation for Tropical Diseases and Environment, Buea, Cameroon.; COUNTDOWN, Department of Sociology and Anthropology, Faculty of Social and Management Sciences, University of Buea, Buea, Cameroon., Mue Nji T; COUNTDOWN, Research Foundation for Tropical Diseases and Environment, Buea, Cameroon.; COUNTDOWN, Department of Sociology and Anthropology, Faculty of Social and Management Sciences, University of Buea, Buea, Cameroon., Ntuen U; Neglected Tropical Disease Programme, Federal Ministry of Health, Government of Nigeria, Abuja, Nigeria., Oluwole A; Sightsavers, Nigeria Country Office, Kaduna State, Nigeria., Piotrowski H; Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom., Siping M; Catholic University of Central Africa, Yaoundé, Cameroon., Tchoffo MN; Catholic University of Central Africa, Yaoundé, Cameroon., Tchuem Tchuenté LA; Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon., Thomson R; Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom., Tsey I; Institutional Review Board, Dodowa Health Research Centre, Ghana Health Service, Dodowa, Ghana., Wanji S; COUNTDOWN, Research Foundation for Tropical Diseases and Environment, Buea, Cameroon.; COUNTDOWN, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon., Yashiyi J; Sightsavers, Nigeria Country Office, Kaduna State, Nigeria., Zawolo G; University of Liberia Pacific Institute for Research and Evaluation, Monrovia, Monsterrado, Liberia., Theobald S; Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom. |
| المصدر: | PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2019 Nov 21; Vol. 13 (11), pp. e0007847. Date of Electronic Publication: 2019 Nov 21 (Print Publication: 2019). |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 101291488 Publication Model: eCollection Cited Medium: Internet ISSN: 1935-2735 (Electronic) Linking ISSN: 19352727 NLM ISO Abbreviation: PLoS Negl Trop Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: San Francisco, CA : Public Library of Science |
| مواضيع طبية MeSH: | Anti-Infective Agents/*therapeutic use , Communicable Diseases/*drug therapy , Communicable Diseases/*epidemiology , Healthcare Disparities/*statistics & numerical data , Mass Drug Administration/*methods , Neglected Diseases/*drug therapy , Neglected Diseases/*epidemiology, Africa ; Female ; Humans ; Male |
| مستخلص: | Introduction: Individuals and communities affected by NTDs are often the poorest and most marginalised; ensuring a gender and equity lens is centre stage will be critical for the NTD community to reach elimination goals and inform Universal Health Coverage (UHC). NTDs amenable to preventive chemotherapy have been described as a 'litmus test' for UHC due to the high mass drug administration (MDA) coverage rates needed to be effective and their model of community engagement. However, until now highly aggregated coverage data may have masked inequities in availability, accessibility and acceptability of medicines, slowing down the equitable achievement of elimination goals. Methods: We conducted qualitative programmatic analysis across different country contexts through the novel application of the Tanahashi Coverage Framework enhanced by gendered intersectional theory to interrogate different components of programme coverage: availability, accessibility, acceptability, contact and effective. Drawing on communities and health implementers perspectives (using focus groups, interviews, and participatory methods) from varying levels of the health system, across four African country contexts (Cameroon, Ghana, Liberia and Nigeria), we show who is left behind and provide recommendations for programmes to respond. Findings: We have unmasked inequities in programme delivery that repeatedly leave vulnerable populations underserved in relation to the prevention and treatment of PC NTDs across all components of coverage explored within the Tanahashi framework. Inequities are influenced by health systems challenges and limitations, due to lack of consideration of gender, power and equity issues. Effective treatment for individuals and communities is shaped by individual identities and the intersecting axes of inequity that converge to shape these positions including gender, age, disability, and geography. Health systems are inherently social and gendered thus they become mediators in managing the impact that social and structural processes have on individual health outcomes. Significance: To our knowledge this is the only paper which has combined a comprehensive equity framework with intersectional feminist theory, to establish a fuller understanding of who is left behind and why in MDA across countries and contexts. Ensuring the most vulnerable have continued access to future treatment options will contribute to the progressive realisation of UHC, allowing the NTD community to continue to support their vision of being a true 'litmus test'. Competing Interests: The authors have declared that no competing interests exist. |
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| المشرفين على المادة: | 0 (Anti-Infective Agents) |
| تواريخ الأحداث: | Date Created: 20191122 Date Completed: 20200211 Latest Revision: 20240722 |
| رمز التحديث: | 20240722 |
| مُعرف محوري في PubMed: | PMC6871774 |
| DOI: | 10.1371/journal.pntd.0007847 |
| PMID: | 31751336 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1935-2735 |
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| DOI: | 10.1371/journal.pntd.0007847 |