Johnston E Anna, Teague Jordan, Graham Jay P
The George Washington University Milken Institute School of Public Health, 950 New Hampshire Ave, NW Suite 400, Washington, DC, 20051, USA.
WASH Advocates, 1506 21st Street NW, Suite 200, Washington, DC, 20036, USA.
BMC Public Health. 2015 Jun 11;15:547. doi: 10.1186/s12889-015-1838-7.
Recent research has suggested that water, sanitation, and hygiene (WASH) interventions, in addition to mass drug administration (MDA), are necessary for controlling and eliminating many neglected tropical diseases (NTDs).
This study investigated the integration of NTD and WASH programming in order to identify barriers to widespread integration and make recommendations about ideal conditions and best practices critical to future integrated programs.
Twenty-four in-depth, semi-structured interviews were conducted with key stakeholders in the global NTD and WASH sectors to identify barriers and ideal conditions in programmatic integration.
The most frequently mentioned barriers to WASH and NTD integration included: 1) differing programmatic objectives in the two sectors, including different indicators and metrics; 2) a disproportionate focus on mass drug administration; 3) differences in the scale of funding; 4) siloed funding; and 5) a lack of coordination and information sharing between the two sectors. Participants also conveyed that a more holistic approach was needed if future integration efforts are to be scaled-up. The most commonly mentioned requisite conditions included: 1) education and advocacy; 2) development of joint indicators; 3) increased involvement at the ministerial level; 4) integrated strategy development; 5) creating task forces or committed partnerships; and 6) improved donor support.
Public health practitioners planning to integrate NTD and WASH programs can apply these results to create conditions for more effective programs and mitigate barriers to success. Donor agencies should consider funding more integration efforts to further test the proof of principle, and additional support from national and local governments is recommended if integration efforts are to succeed. Intersectoral efforts that include the development of shared indicators and objectives are needed to foster conditions conducive to expanding effective integration programs.
近期研究表明，除大规模药物给药（MDA）外，水、环境卫生和个人卫生（WASH）干预措施对于控制和消除多种被忽视的热带病（NTD）是必要的。
本研究调查了NTD与WASH规划的整合情况，以确定广泛整合的障碍，并就对未来综合项目至关重要的理想条件和最佳实践提出建议。
对全球NTD和WASH领域的关键利益相关者进行了24次深入的半结构化访谈，以确定项目整合中的障碍和理想条件。
WASH与NTD整合中最常被提及的障碍包括：1）两个领域不同的项目目标，包括不同的指标和衡量标准；2）对大规模药物给药的过度关注；3）资金规模的差异；4）资金分散；5）两个领域之间缺乏协调和信息共享。参与者还表示，如果未来要扩大整合工作，需要采取更全面的方法。最常被提及的必要条件包括：1）教育和宣传；2）制定联合指标；3）增加部级层面的参与；4）制定综合战略；5）创建特别工作组或建立坚定的伙伴关系；6）改善捐助方支持。
计划整合NTD和WASH项目的公共卫生从业者可以应用这些结果，为更有效的项目创造条件，并减少成功的障碍。捐助机构应考虑为更多的整合工作提供资金，以进一步验证原则，并建议如果整合工作要取得成功，国家和地方政府提供更多支持。需要开展包括制定共享指标和目标在内的跨部门努力，以营造有利于扩大有效整合项目的条件。
