Empowering communities to deliver public health interventions: The use of community drug distributors for ntd prevention and control in Tanzania

In Tanzania, over 45 million people are at risk of infection of 2 or more Neglected Tropical Diseases (NTDs). Recognizing the need for increased efficiency in a resource limited environment, the Ministry of Health and Social Welfare NTD Control Program adopted the community directed treatment strategy. Communities take responsibility for organizing annual mass drug administration (MDA) and play a crucial role in the success of the program. Communities select two people, male and female, who will serve as community drug distributers during the MDA campaign. They sensitize the community about the program and deliver the treatments door to door. Front line health workers (FLHW) train the CDDs on the importance of annual MDA, drug dosage, reporting, and provide supportive supervision during MDA. The use of local CDDs has enabled the program to reach remote villages and facilitated community ownership of the program. Between October 2011 and September 2012, the program trained 3,500 FLHWs and 41,000 CDDs. CDDs distributed over 14 million doses of NTD preventing medication. Public health interventions targeting hard to reach communities should consider engaging community members at all stages of program planning, implementation, and monitoring and evaluation. The NTD Control Program in Tanzania provides a good example of how a large scale program with complicated logistics can target the prevention of multiple diseases successfully through the combined effort of government, donors, partners, and local communities