Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK.
Sightsavers Nigeria, 800241 Kaduna, Nigeria.
Int Health. 2023 Mar 24;15(Suppl 1):i87-i99. doi: 10.1093/inthealth/ihac084.
Neglected tropical diseases (NTDs) affect around 1 billion people, many living in the poorest parts of the world. NTDs often lead to serious long-term physical impairments. Stigma, disability, poverty and social isolation interact, resulting in poor quality of life and significant psychosocial impacts. The holistic health and psychosocial needs of persons affected by NTDs are often overlooked in integrated NTD programme design and research. Furthermore, the viewpoints of persons affected are often absent and spaces for empowerment and advocacy are limited.
Using a community-based participatory research design, our study partnered with persons affected and caregivers as co-researchers to address this gap. Through the process, we co-designed and implemented community-based support groups in Kaduna and Kwara, Nigeria, where NTDs are endemic. This paper utilises photovoice with support group facilitators (persons affected); participant observation of group meetings; rapid micronarratives with support group members; and key informant interviews with programme implementers at the state and local government area levels to explore the impact of the support groups from the perspective of people affected by NTDs and other health system actors.
Perceived impacts of the support groups included a sense of ownership and empowerment, stigma reduction, improved self-esteem, improved health knowledge and health outcomes and capacity strengthening through vocational training.
Support groups, as community spaces of healing, offer a low-cost holistic intervention for chronic disease and disability.
被忽视的热带病(NTDs)影响了大约 10 亿人,其中许多人生活在世界上最贫穷的地区。NTDs 常常导致严重的长期身体损伤。耻辱、残疾、贫困和社会孤立相互作用,导致生活质量低下和严重的心理社会影响。受 NTD 影响者的整体健康和心理社会需求在综合 NTD 规划设计和研究中经常被忽视。此外,受影响者的观点往往缺失,赋权和宣传的空间有限。
我们的研究采用基于社区的参与式研究设计,与受影响者及其护理人员合作,作为共同研究者来解决这一差距。在此过程中,我们在尼日利亚卡杜纳和夸拉州共同设计和实施了以社区为基础的支持小组,这些地方是 NTD 的流行地区。本文利用有支持小组协调员(受影响者)参与的摄影展、对小组会议的参与观察、对支持小组成员的快速微叙事、以及与州和地方政府层面的方案执行者的关键知情人访谈,从受 NTD 影响者和其他卫生系统行为者的角度探讨支持小组的影响。
支持小组的感知影响包括归属感和赋权感、耻辱感减轻、自尊心提高、健康知识和健康结果改善以及通过职业培训增强能力。
支持小组作为治疗的社区空间,为慢性病和残疾提供了一种低成本的整体干预措施。