142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Strengthening local health systems to address Lymphatic Filariasis (LF) morbidity in a resource limited setting: A morbidity management project in the Lindi region of Tanzania

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 1:06 PM - 1:18 PM

Deogratias Damas, MD , IMA World Health, Washington, DC
In Tanzania, lymphatic filariasis (LF) affects over 6 million people leading to a high burden of LF associated hydrocele: a fluid-filled enlargement of the tunica vaginalis sac around the testes. The economic, physical, and psychosocial impact of hydrocele is devastating not only for the individual, but also for the family and community. In the Lindi region alone, one of 30 regions in Tanzania, there was a backlog of 2000 men awaiting hydrocele surgery in 2011.  However, most patients did not access surgeries due to 1) inability to pay as almost 90% of patients depend on out of pocket payment; 2) an inadequate number of skilled clinicians performing surgeries; 3) limited medical supplies; and 4) patients’ fear of undergoing a non-emergency surgery under general anesthesia. To address these obstacles, the project focused on strengthening the local health system by pooling resources from stakeholders (donor, MOH, national referral hospital, regional/district hospitals, and communities) to allow for surgeries free of charge and to provide required supplies. Experienced surgeons mentored 29 local doctors and nurses on hydrocelectomy using sac partial excision technique under local anesthesia.  Also, they were provided a small incentive to conduct surgeries over weekends to avoid interfering with regular weekly duties.  By strengthening the local health workforce, pooling resources, and increasing availability of supplies, 680 patients accessed quality hydrocelectomy over 8 months; over 4 times the annual average of hydrocelectomy surgeries performed regionally before the intervention.  This intervention can be sustained through increased local capacity and ownership within district level staff.

Learning Areas:

Provision of health care to the public

Learning Objectives:
Evaluate how pooling and leveraging stakeholder resources can help to address interventions for typically under funded, or low profile conditions.

Keyword(s): Accessibility, Funding/Financing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Deogratias Damas is an MD and public health professional. He serves as Senior Program Manager at IMA World Health where he manages the USAID Envision program which supports the Tanzania NTD Control Program. Dr. Damas was instrumental in developing the MDA scale-up strategy conducted with the MOH. He has extensive M&E experience with conducting epidemiological study methods and has conducted population based surveys for Trachoma and MDA through baseline and impact surveys.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.