Unlocking Trust in Community Health Systems: Lessons From the Lymphatic Filariasis Morbidity Management and Disability Prevention Pilot Project in Luangwa District, Zambia
Background Surgery for hydrocele is commonly promoted as part of morbidity management and disability prevention (MMDP) services for lymphatic filariasis (LF). However, uptake of these surgeries has been suboptimal owing to several community level barriers that have triggered mistrust in such servic...
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| Format: | Article |
| Language: | English |
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Kerman University of Medical Sciences
2022-01-01
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| Series: | International Journal of Health Policy and Management |
| Subjects: | |
| Online Access: | https://www.ijhpm.com/article_4141_e1d76874eb6a4b344da586e79a90bb92.pdf |
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| author | Joseph M. Zulu Patricia Maritim Adam Silumbwe Hikabasa Halwiindi Patricia Mubita George Sichone Chileshe H. Mpandamabula Frank Shamilimo Charles Michelo |
| author_facet | Joseph M. Zulu Patricia Maritim Adam Silumbwe Hikabasa Halwiindi Patricia Mubita George Sichone Chileshe H. Mpandamabula Frank Shamilimo Charles Michelo |
| author_sort | Joseph M. Zulu |
| collection | DOAJ |
| description | Background Surgery for hydrocele is commonly promoted as part of morbidity management and disability prevention (MMDP) services for lymphatic filariasis (LF). However, uptake of these surgeries has been suboptimal owing to several community level barriers that have triggered mistrust in such services. This study aimed at documenting mechanisms of unlocking trust in community health systems (CHSs) in the context of a LF hydrocele management project that was implemented in Luangwa District, Zambia. Methods Qualitative data was collected through in-depth interviews (IDIs) and focus group discussions (FGDs) (n = 45) in February 2020 in Luangwa District. Thirty-one IDIs were conducted with hydrocele patients, community health workers (CHWs), health workers, traditional leaders and traditional healers. Two FGDs were also conducted with CHWs who had been involved in project implementation with seven participants per group. Data was analyzed using a thematic analysis approach. Results The use of locally appropriate communication strategies, development of community driven referral systems, working with credible community intermediaries as well as strengthening health systems capacity through providing technical and logistical support enhanced trust in surgery for hydrocele and uptake of the surgeries. Conclusion Implementation of community led communication and referral systems as well as strengthening health services are vital in unlocking trust in health systems as such mechanisms trigger authentic partnerships, including mutual respect and recognition in the CHS. The mechanisms also enhance confidence in health services among community members. |
| first_indexed | 2024-04-10T05:30:22Z |
| format | Article |
| id | doaj.art-956ae876d155481fbc7477535e83c281 |
| institution | Directory Open Access Journal |
| issn | 2322-5939 |
| language | English |
| last_indexed | 2024-04-10T05:30:22Z |
| publishDate | 2022-01-01 |
| publisher | Kerman University of Medical Sciences |
| record_format | Article |
| series | International Journal of Health Policy and Management |
| spelling | doaj.art-956ae876d155481fbc7477535e83c2812023-03-07T09:09:45ZengKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59392022-01-0111Special Issue on CHS-Connect808910.34172/ijhpm.2021.1334141Unlocking Trust in Community Health Systems: Lessons From the Lymphatic Filariasis Morbidity Management and Disability Prevention Pilot Project in Luangwa District, ZambiaJoseph M. Zulu0Patricia Maritim1Adam Silumbwe2Hikabasa Halwiindi3Patricia Mubita4George Sichone5Chileshe H. Mpandamabula6Frank Shamilimo7Charles Michelo8Department of Health Promotion and Education, School of Public Health, The University of Zambia, Lusaka, ZambiaDepartment of Health Policy and Management, School of Public Health, The University of Zambia, Lusaka, ZambiaDepartment of Health Policy and Management, School of Public Health, The University of Zambia, Lusaka, ZambiaDepartment of Community and Family Medicine, School of Public Health, The University of Zambia, Lusaka, ZambiaDepartment of Environmental Health, School of Public Health, The University of Zambia, Lusaka, ZambiaParticipatory Research and Innovations Management (PRIM), Lusaka, ZambiaRigor Data Research, Consultancy Firm, Lusaka, ZambiaMinistry of Health, Lusaka, ZambiaDepartment of Epidemiology and Biostatistics, School of Public Health, The University of Zambia, Lusaka, ZambiaBackground Surgery for hydrocele is commonly promoted as part of morbidity management and disability prevention (MMDP) services for lymphatic filariasis (LF). However, uptake of these surgeries has been suboptimal owing to several community level barriers that have triggered mistrust in such services. This study aimed at documenting mechanisms of unlocking trust in community health systems (CHSs) in the context of a LF hydrocele management project that was implemented in Luangwa District, Zambia. Methods Qualitative data was collected through in-depth interviews (IDIs) and focus group discussions (FGDs) (n = 45) in February 2020 in Luangwa District. Thirty-one IDIs were conducted with hydrocele patients, community health workers (CHWs), health workers, traditional leaders and traditional healers. Two FGDs were also conducted with CHWs who had been involved in project implementation with seven participants per group. Data was analyzed using a thematic analysis approach. Results The use of locally appropriate communication strategies, development of community driven referral systems, working with credible community intermediaries as well as strengthening health systems capacity through providing technical and logistical support enhanced trust in surgery for hydrocele and uptake of the surgeries. Conclusion Implementation of community led communication and referral systems as well as strengthening health services are vital in unlocking trust in health systems as such mechanisms trigger authentic partnerships, including mutual respect and recognition in the CHS. The mechanisms also enhance confidence in health services among community members.https://www.ijhpm.com/article_4141_e1d76874eb6a4b344da586e79a90bb92.pdftrustcommunity health systemshydrocelemorbidity managementdisability preventionzambia |
| spellingShingle | Joseph M. Zulu Patricia Maritim Adam Silumbwe Hikabasa Halwiindi Patricia Mubita George Sichone Chileshe H. Mpandamabula Frank Shamilimo Charles Michelo Unlocking Trust in Community Health Systems: Lessons From the Lymphatic Filariasis Morbidity Management and Disability Prevention Pilot Project in Luangwa District, Zambia International Journal of Health Policy and Management trust community health systems hydrocele morbidity management disability prevention zambia |
| title | Unlocking Trust in Community Health Systems: Lessons From the Lymphatic Filariasis Morbidity Management and Disability Prevention Pilot Project in Luangwa District, Zambia |
| title_full | Unlocking Trust in Community Health Systems: Lessons From the Lymphatic Filariasis Morbidity Management and Disability Prevention Pilot Project in Luangwa District, Zambia |
| title_fullStr | Unlocking Trust in Community Health Systems: Lessons From the Lymphatic Filariasis Morbidity Management and Disability Prevention Pilot Project in Luangwa District, Zambia |
| title_full_unstemmed | Unlocking Trust in Community Health Systems: Lessons From the Lymphatic Filariasis Morbidity Management and Disability Prevention Pilot Project in Luangwa District, Zambia |
| title_short | Unlocking Trust in Community Health Systems: Lessons From the Lymphatic Filariasis Morbidity Management and Disability Prevention Pilot Project in Luangwa District, Zambia |
| title_sort | unlocking trust in community health systems lessons from the lymphatic filariasis morbidity management and disability prevention pilot project in luangwa district zambia |
| topic | trust community health systems hydrocele morbidity management disability prevention zambia |
| url | https://www.ijhpm.com/article_4141_e1d76874eb6a4b344da586e79a90bb92.pdf |
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