Structured discussions known as community dialogues are being used in communities in Mozambique as a way of improving health-seeking behaviours and knowledge surrounding schistosomiasis – one of the most widespread and harmful of the so-called neglected tropical diseases (NTDs). Schistosomiasis is an infectious disease spread by freshwater snails, which release an infected parasite into bodies of water where children and other at-risk groups are particularly susceptible when their skin comes into contact with contaminated water. The disease affects over 42 million people each year and poses a huge economic burden on vulnerable populations.
The community dialogues are taking place in four districts in Nampula province and form part of Malaria Consortium’s project on the effectiveness of community dialogues for the prevention and control of NTDs, conducted through COMDIS-HSD, a Research Programme Consortium funded by UK aid from the UK Government. The project is also supported by a Grand Challenges for Global Health grant awarded to Malaria Consortium by the Bill & Melinda Gates Foundation.
The World Health Organization currently prioritises 17 NTDs, which are all chronically underfunded and which cause a disproportionate amount of damage among low-resource communities in developing countries. Of these 17, five diseases (including schistosomiasis) can be prevented through the distribution of drugs to whole populations residing in high-risk areas. These mass drug administration (MDA) interventions involve the distribution of drugs to everyone regardless of disease status. However, delivery of MDA has been inconsistent due to a variety of obstacles, including low uptake due to negative perceptions of the intervention. In addition to MDA, successful prevention and control of NTDs also requires the adoption of preventive behaviours such as basic sanitation and hygiene practices.
The community dialogues being implemented in Mozambique are intended to improve community ownership of schistosomiasis prevention and control, including MDA and improved sanitation. The dialogues bring together residents to discuss health issues critical within their communities, and increase understanding of diseases as well as appropriate responses.
Approximately 150 community-based facilitators were trained by Malaria Consortium and community dialogues are now conducted in approximately 65 communities. Each community will hold about 10 community dialogue meetings over a period of six months, which will be assessed for their effectiveness in improving community participation and health outcomes.