Community participation in the eradication of guinea worm disease

As Guinea worm eradication programmess have got under way in endemic countries over the last decade, there has been shift toward more participatory methods. The approach to surveillance has changed from periodic cross-sectional surveys to monthly village-based reporting of cases by a volunteer village health worker. At the same time, the emphasis regarding control interventions has moved from the provision of safe water supplied to health educatioon. The new approach has proved very effective. The village health volunteers who carry out both surveillance and health seem to be motivated largerly by the the social status of their role; still more commitment will the required of them in the final stages of eradication. It is be hoped that the networks of village health workers established for Guinea worm eradication will find a useful role in health promotion after the worms have gone.