Kuper Hannah, Solomon Anthony W, Buchan John C, Zondervan Marcia, Mabey David, Foster Allen
London School of Hygiene and Tropical Medicine, London, UK.
Trop Med Int Health. 2005 Aug;10(8):764-72. doi: 10.1111/j.1365-3156.2005.01451.x.
Trachoma is a major cause of blindness. The objective of this initiative was to conduct participatory process evaluations of the trachoma control programmes receiving support from the International Trachoma Initiative in eight countries.
During each 2- to 4-week evaluation we analysed information collected at the central, district and community level through interviews, focus groups, questionnaires, direct observation of trachoma control activities, and existing data.
Mapping and assessment of disease prevalence had been completed in four of eight countries. Integration of trachoma control activities into national planning and district-level service provision varied. Intersectoral partnerships to implement the SAFE strategy (i.e. surgery, antibiotics, facial cleanliness and environmental change) were well established in a few countries. In all eight countries, the number of surgeries performed annually was insufficient; and quality of surgery was rarely monitored. Mass distribution of antibiotics was carried out well in extremely resource-poor settings and good coverage was achieved, although the strategy for antibiotic distribution varied. Inadequate water and sanitation remained a major problem in all programme areas. Monitoring of programme activities was generally inadequate. The Morocco programme is an example from which lessons and processes can be learnt and adapted to other programme countries.
Significant achievements have been made in implementing the SAFE strategy. Scaling up of activities to true national coverage should be planned and implemented provided the resources can be made available. Further standardization of how to assess, implement and monitor trachoma control activities will facilitate expansion of the programme.
沙眼是导致失明的主要原因。该倡议的目标是对八个国家中接受国际沙眼倡议支持的沙眼控制项目进行参与式过程评估。
在每次为期2至4周的评估期间，我们通过访谈、焦点小组、问卷调查、直接观察沙眼控制活动以及现有数据，分析在中央、地区和社区层面收集到的信息。
八个国家中有四个国家已完成疾病患病率的测绘和评估。沙眼控制活动纳入国家规划和地区级服务提供的情况各不相同。在少数几个国家，实施SAFE策略（即手术、抗生素、面部清洁和环境改善）的跨部门伙伴关系已建立完善。在所有八个国家，每年进行的手术数量都不足；而且手术质量很少受到监测。在资源极度匮乏的地区，抗生素的大规模分发开展得很好，覆盖率也很高，尽管抗生素分发策略各不相同。水和卫生设施不足在所有项目地区仍然是一个主要问题。对项目活动的监测总体上不足。摩洛哥项目是一个可以吸取经验教训并将相关流程应用于其他项目国家的范例。
在实施SAFE策略方面已取得显著成就。如果能够获得资源，应规划并实施将活动扩大到真正覆盖全国范围的工作。进一步规范沙眼控制活动的评估、实施和监测方式将有助于该项目的扩展。
