Development of an integrated and decentralised skin health strategy to improve experiences of skin neglected tropical diseases and other skin conditions in Atwima Mponua District, Ghana.

Autor:	Phillips RO; Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.; School of Medicine and Dentistry, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana., Owusu L; Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana., Koka E; Department of Sociology and Anthropology, University of Cape Coast, Cape Coast, Ghana., Ocloo EK; Department of Sociology and Anthropology, University of Cape Coast, Cape Coast, Ghana.; Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana., Simpson H; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom., Agbanyo A; Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana., Okyere D; Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana., Tuwor RD; Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana., Fokuoh-Boadu A; Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana., Akuffo RA; Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana., Novignon J; Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.; Department of Economics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana., Oppong MN; Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana., Mosweu I; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom., Asante-Poku A; Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana., Cobbinah J; Atwima Mponua District Health Directorate, Nhinahin, Ghana., Mtuy TB; Hospital for Tropical Diseases, University College London Hospital, London, United Kingdom., Palmer J; Hospital for Tropical Diseases, University College London Hospital, London, United Kingdom., Ahorlu C; Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana., Amoako YA; Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.; School of Medicine and Dentistry, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana., Walker SL; Hospital for Tropical Diseases, University College London Hospital, London, United Kingdom., Yeboah-Manu D; Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana., Marks M; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.; Hospital for Tropical Diseases, University College London Hospital, London, United Kingdom.; Division of Infection and Immunity, University College London, London, United Kingdom., Pitt C; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom., Pullan R; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2024 Jan 19; Vol. 4 (1), pp. e0002809. Date of Electronic Publication: 2024 Jan 19 (Print Publication: 2024).
DOI:	10.1371/journal.pgph.0002809
Abstrakt:	Integrated strategies are recommended to tackle neglected tropical diseases of the skin (skin NTDs), which pose a substantial health and economic burden in many countries, including Ghana. We describe the development of an integrated and decentralised skin health strategy designed to improve experiences of skin NTDs in Atwima Mponua district in Ashanti Region. A multidisciplinary research team led an iterative process to develop an overall strategy and specific interventions, based on a theory of change informed by formative research conducted in Atwima Mponua district. The process involved preparatory work, four co-development workshops (August 2021 to November 2022), collaborative working groups to operationalise intervention components, and obtaining ethical approval. Stakeholders including affected individuals, caregivers, other community members and actors from different levels of the health system participated in co-development activities. We consulted these stakeholders at each stage of the research process, including discussion of study findings, development of our theory of change, identifying implementable solutions to identified challenges, and protocol development. Participants determined that the intervention should broadly address wounds and other skin conditions, rather than only skin NTDs, and should avoid reliance on non-governmental organisations and research teams to ensure sustainable implementation by district health teams and transferability elsewhere. The overall strategy was designed to focus on a decentralised model of care for skin conditions, while including other interventions to support a self-care delivery pathway, community engagement, and referral. Our theory of change describes the pathways through which these interventions are expected to achieve the strategy's aim, the assumptions, and problems addressed. This complex intervention strategy has been designed to respond to the local context, while maximising transferability to ensure wider relevance. Implementation is expected to begin in 2023. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2024 Phillips et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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