TY - JOUR
T1 - Developing a Buruli ulcer community of practice in Bankim, Cameroon
T2 - A model for Buruli ulcer outreach in Africa
AU - Stop Buruli Consortium
AU - Awah, Paschal Kum
AU - Boock, Alphonse Um
AU - Mou, Ferdinand
AU - Koin, Joseph Tohnain
AU - Anye, Evaristus Mbah
AU - Noumen, Djeunga
AU - Nichter, Mark
N1 - Funding Information:
This research was funded by the Optimus Foundation as part of the Stop Buruli Initiative. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Dr. Earnest Njih Tabah from Cameroon’s national NTD program provided valuable advice during this project. The Paramount Chief of the Tikars (Chief Ngah) and local chiefs enabled the project and its activities. We would also like to acknowledge the participation of the traditional healers and community health workers who played an active role in the project as well as Bankim Health district hospital and satellite clinic staff. Special thanks go to Christian Minyem and Minyem Jacques for assisting in laboratory confirmation of BU cases, and fact checking. Paschal Kum Awah, Alphonse Um Boock, Ferdinand Mou, Joseph Tohnain Koin, Evaristus Mbah Anye, and Mark Nichter ae members of the Stop Buruli Consortium
Publisher Copyright:
© 2018 Awah et al.
PY - 2018/3/27
Y1 - 2018/3/27
N2 - Background: In the Cameroon, previous efforts to identify Buruli ulcer (BU) through the mobilization of community health workers (CHWs) yielded poor results. In this paper, we describe the successful creation of a BU community of practice (BUCOP) in Bankim, Cameroon composed of hospital staff, former patients, CHWs, and traditional healers. Methods and principle findings: All seven stages of a well-defined formative research process were conducted during three phases of research carried out by a team of social scientists working closely with Bankim hospital staff. Phase one ethnographic research generated interventions tested in a phase two proof of concept study followed by a three- year pilot project. In phase three the pilot project was evaluated. An outcome evaluation documented a significant rise in BU detection, especially category I cases, and a shift in case referral. Trained CHW and traditional healers initially referred most suspected cases of BU to Bankim hospital. Over time, household members exposed to an innovative and culturally sensitive outreach education program referred the greatest number of suspected cases. Laboratory confirmation of suspected BU cases referred by community stakeholders was above 30%. An impact and process evaluation found that sustained collaboration between health staff, CHWs, and traditional healers had been achieved. CHWs came to play a more active role in organizing BU outreach activities, which increased their social status. Traditional healers found they gained more from collaboration than they lost from referral. Conclusion/ Significance: Setting up lines of communication, and promoting collaboration and trust between community stakeholders and health staff is essential to the control of neglected tropical diseases. It is also essential to health system strengthening and emerging disease preparedness. The BUCOP model described in this paper holds great promise for bringing communities together to solve pressing health problems in a culturally sensitive manner.
AB - Background: In the Cameroon, previous efforts to identify Buruli ulcer (BU) through the mobilization of community health workers (CHWs) yielded poor results. In this paper, we describe the successful creation of a BU community of practice (BUCOP) in Bankim, Cameroon composed of hospital staff, former patients, CHWs, and traditional healers. Methods and principle findings: All seven stages of a well-defined formative research process were conducted during three phases of research carried out by a team of social scientists working closely with Bankim hospital staff. Phase one ethnographic research generated interventions tested in a phase two proof of concept study followed by a three- year pilot project. In phase three the pilot project was evaluated. An outcome evaluation documented a significant rise in BU detection, especially category I cases, and a shift in case referral. Trained CHW and traditional healers initially referred most suspected cases of BU to Bankim hospital. Over time, household members exposed to an innovative and culturally sensitive outreach education program referred the greatest number of suspected cases. Laboratory confirmation of suspected BU cases referred by community stakeholders was above 30%. An impact and process evaluation found that sustained collaboration between health staff, CHWs, and traditional healers had been achieved. CHWs came to play a more active role in organizing BU outreach activities, which increased their social status. Traditional healers found they gained more from collaboration than they lost from referral. Conclusion/ Significance: Setting up lines of communication, and promoting collaboration and trust between community stakeholders and health staff is essential to the control of neglected tropical diseases. It is also essential to health system strengthening and emerging disease preparedness. The BUCOP model described in this paper holds great promise for bringing communities together to solve pressing health problems in a culturally sensitive manner.
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U2 - 10.1371/journal.pntd.0006238
DO - 10.1371/journal.pntd.0006238
M3 - Article
C2 - 29584724
AN - SCOPUS:85045083552
SN - 1935-2727
VL - 12
JO - PLoS neglected tropical diseases
JF - PLoS neglected tropical diseases
IS - 3
M1 - e0006238
ER -