Department of Global Health, University of Washington, Seattle, Washington, United States of America.
DeWorm3, Natural History Museum, London, United Kingdom.
PLoS Negl Trop Dis. 2018 Feb 8;12(2):e0006211. doi: 10.1371/journal.pntd.0006211. eCollection 2018 Feb.
Community-based public health campaigns, such as those used in mass deworming, vitamin A supplementation and child immunization programs, provide key healthcare interventions to targeted populations at scale. However, these programs often fall short of established coverage targets. The purpose of this systematic review was to evaluate the impact of strategies used to increase treatment coverage in community-based public health campaigns.
METHODOLOGY/ PRINCIPAL FINDINGS: We systematically searched CAB Direct, Embase, and PubMed archives for studies utilizing specific interventions to increase coverage of community-based distribution of drugs, vaccines, or other public health services. We identified 5,637 articles, from which 79 full texts were evaluated according to pre-defined inclusion and exclusion criteria. Twenty-eight articles met inclusion criteria and data were abstracted regarding strategy-specific changes in coverage from these sources. Strategies used to increase coverage included community-directed treatment (n = 6, pooled percent change in coverage: +26.2%), distributor incentives (n = 2, +25.3%), distribution along kinship networks (n = 1, +24.5%), intensified information, education, and communication activities (n = 8, +21.6%), fixed-point delivery (n = 1, +21.4%), door-to-door delivery (n = 1, +14.0%), integrated service distribution (n = 9, +12.7%), conversion from school- to community-based delivery (n = 3, +11.9%), and management by a non-governmental organization (n = 1, +5.8%).
CONCLUSIONS/SIGNIFICANCE: Strategies that target improving community member ownership of distribution appear to have a large impact on increasing treatment coverage. However, all strategies used to increase coverage successfully did so. These results may be useful to National Ministries, programs, and implementing partners in optimizing treatment coverage in community-based public health programs.
以社区为基础的公共卫生运动，如大规模驱虫、维生素 A 补充和儿童免疫规划等，为目标人群提供了大规模的关键医疗干预措施。然而，这些规划往往未能达到既定的覆盖目标。本系统评价的目的是评估旨在提高社区公共卫生运动中治疗覆盖的策略的影响。
方法/主要发现：我们系统地在 CAB Direct、Embase 和 PubMed 档案中搜索了利用特定干预措施来提高社区分发药物、疫苗或其他公共卫生服务覆盖的研究。我们共发现了 5637 篇文章，其中 79 篇全文根据预先确定的纳入和排除标准进行了评估。28 篇文章符合纳入标准，从这些来源中提取了关于覆盖策略特定变化的数据。用于提高覆盖的策略包括社区导向治疗（n=6，覆盖百分比变化的总和：+26.2%）、分销商激励（n=2，+25.3%）、沿着亲属网络分配（n=1，+24.5%）、强化信息、教育和宣传活动（n=8，+21.6%）、定点配送（n=1，+21.4%）、挨家挨户配送（n=1，+14.0%）、综合服务配送（n=9，+12.7%）、从学校到社区配送的转换（n=3，+11.9%）和由非政府组织管理（n=1，+5.8%）。
结论/意义：旨在提高社区成员对分配的所有权的策略似乎对提高治疗覆盖有很大的影响。然而，所有成功提高覆盖的策略都做到了这一点。这些结果可能对国家部委、规划和实施伙伴在优化社区公共卫生规划中的治疗覆盖有用。
