African Programme for Onchocerciasis Control (APOC)

Strengthening health systems

The success of community-directed treatment (CDTI), especially in remote areas of countries torn by conflict and war, has opened the doors to a number of other health care interventions that lend themselves to the CDTI approach.

A regional health centre
WHO/APOC/Hannah Brown
A regional health centre serving 10 villages in the remote northern rainforest of Democratic Republic of Congo

The enthusiasm of communities for helping themselves means this strategy is now being extended beyond onchocerciasis. The trained volunteers, or community-directed distributors, are being trained to take on a variety of other health care tasks including:

  • distributing vitamin A tablets
  • distributing deworming tablets (e.g. albendazole and mebendazole)
  • distributing chloroquine for home-based treatment of malaria in remote villages
  • identifying cataract patients
  • mobilizing community support for routine immunization services
  • mobilizing children for polio vaccination
  • helping to look for signs of tuberculosis.

The ineffectiveness of many African health systems means that these interventions often do not reach the people who need them. By participating in other health care measures, the community volunteers – who span sub-Saharan Africa and number more than 470 000 – are helping to supplement and reinforce these weak health systems.

Map showing the number of community-directed treatment (CDTI) projects that supply additional public health interventions