Guinea worm wrap-up ; # 79, June 15, 1998
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  • English

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    • Journal Article:
      Guinea worm wrap-up
    • Description:
      Over the past several years, evaluations and consultations to national Guinea Worm Eradication Programs have consistently highlighted the importance and frequent inadequacy of supervision of village-based health workers and/or village volunteers in almost every program which has been reviewed. Programs must correct this crucial weakness in order to stop transmission in the remaining endemic areas. If village-based workers don=t do their jobs properly, programs cannot succeed. It is a major responsibility of staff at national and district levels of Guinea Worm Eradication Programs to ensure that village-based health workers get the support they need in order to perform their duties correctly.

      The three essential duties of village-level workers are:

      • to actively search for cases of dracunculiasis in the areas for which they are responsible, record information about each patient in a village case register, and report any cases detected monthly. The standard of performance for this task is that every case should be detected within 24 hours of emergence of the worm;

      • to apply appropriate containment measures immediately after discovery of each case; and

      • to help mobilize and educate their communities to report cases immediately, prevent entry of patients into drinking sources, always filter unsafe drinking water, seek provision of safe sources of drinking water, and cooperate with the use of Abate.

      Regular, effective supervision of village-based workers (VBW) is the key to helping them perform their essential tasks well. Supervisors should visit each village-based worker at least monthly (twice a month if possible), and use a checklist to make sure that all important activities are reviewed. The quality and quantity of supervisory visits are both important. If conducted properly, such regular supportive visits will serve as inservice training, thereby helping and encouraging each VBW to improve his or her performance until the desired level is attained, and then to maintain that level of performance. In addition to providing a checklist for supervisory visits, programs should ensure that all supervisors at each level have the support they need to do their jobs. For example, suitable transportation (motorbikes, bicycles, fuel, maintenance, etc.) when needed, sufficient compensation so that field supervisors are paid for extra expenses when they are away from the office, and adequate supplies (replenishments for first aid kits, forms, filters, any appropriate incentives or rewards, if applicable) to leave with the VBWs. Programs should also establish clear priorities for the highest endemic geographic areas on which to concentrate scarce time, fuel, and other resources for assuring regular supervision.

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