“Using the same hand”: the complex local perceptions of integrated one health based interventions in East Africa

Davis, A. , Virhia, J., Bunga, C., Alkara, S., Cleaveland, S. , Yoder, J., Kinung’hi, S. and Lankester, F. (2022) “Using the same hand”: the complex local perceptions of integrated one health based interventions in East Africa. PLoS Neglected Tropical Diseases, 16(4), e0010298. (doi: 10.1371/journal.pntd.0010298) (PMID:35377878) (PMCID:PMC9009769)

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Abstract

Background: Neglected Tropical Diseases (NTDs) such as soil transmitted helminths (STH) and human rabies represent a significant burden to health in East Africa. Control and elimination remains extremely challenging, particularly in remote communities. Novel approaches, such as One Health based integrated interventions, are gaining prominence, yet there is more to be learned about the ways in which social determinants affect such programmes. Methodology: In 2015 a mixed method qualitative study was conducted in northern Tanzania to determine community perceptions towards integrated delivery of two distinct healthcare interventions: treatment of children for STH and dog vaccination for rabies. In order to assess the effectiveness of the integrated approach, villages were randomly allocated to one of three intervention arms: i) Arm A received integrated mass drug administration (MDA) for STH and mass dog rabies vaccination (MDRV); ii) Arm B received MDA only; iii) Arm C received MDRV only. Principle findings: Integrated interventions were looked upon favourably by communities with respondents in all arms stating that they were more likely to either get their dogs vaccinated if child deworming was delivered at the same time and vice versa. Participants appreciated integrated interventions, due to time and cost savings and increased access to essential health care. Analysis of qualitative data allowed deeper exploration of responses, revealing why people appreciated these benefits as well as constraints and barriers to participation in integrated programmes. Conclusions/significance: An interdisciplinary One Health approach that incorporates qualitative social science can provide key insights into complex local perceptions for integrated health service delivery for STH and human rabies. This includes providing insights into how interventions can be improved while acknowledging and addressing critical issues around awareness, participation and underlying health disparities in remote pastoralist communities.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lankester, Dr Felix and Cleaveland, Professor Sarah and Davis, Dr Alicia and Virhia, Miss Jennika
Creator Roles:
Davis, A.Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Supervision, Writing – original draft, Writing – review and editing
Virhia, J.Conceptualization, Formal analysis, Writing – original draft, Writing – review and editing
Cleaveland, S.Conceptualization, Funding acquisition, Methodology, Supervision, Writing – review and editing
Lankester, F.Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Project administration, Visualization, Writing – original draft, Writing – review and editing
Authors: Davis, A., Virhia, J., Bunga, C., Alkara, S., Cleaveland, S., Yoder, J., Kinung’hi, S., and Lankester, F.
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences
Journal Name:PLoS Neglected Tropical Diseases
Publisher:Public Library of Science
ISSN:1935-2727
ISSN (Online):1935-2735
Published Online:04 April 2022
Copyright Holders:Copyright © 2022 Davis et al.
First Published:First published in PLoS Neglected Tropical Diseases 16(4): e0010298
Publisher Policy:Reproduced under a Creative Commons License
Data DOI:10.5525/gla.researchdata.1252

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
174009Supporting Evidence-Based Interventions to Achieve Agricultural Development Goals (SEBI)Sarah CleavelandBill and Melinda Gates Foundation (GATES)OPP1134229Institute of Biodiversity, Animal Health and Comparative Medicine