Guineaworm control case study: Planning a multi-strategy approach

William R. Brieger, Jayashree Ramakrishna, Joshua D. Adeniyi, M. K.C. Sridhar, Oladele O. Kale

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


The planned global eradication of guineaworm (dracunculiasis) offers opportunities to learn about relatively complicated disease control situations. Unlike smallpox, which was eradicated over 10 years ago through immunization, the guineaworm problem has no one solution, but must rely on a variety of technologies to protect, treat or replace existing unsafe community water supplies which harbour the disease. Experiences in rural Nigeria have shown that a multi-strategy approach is necessary to account for differences in geographical settlement patterns, local culture and beliefs, geology of the area, economy of the villages and political clout of town leaders among the five major segments of the community. Through a self-help primary health care programme, residents of the Idere community were able to dig wells, produce and distribute cloth water filters bringing a reduction in disease incidence in some areas. It was also seen that generally low standards of living exacerbated by scattered outlying settlements made self-help difficult. Unfortunately occasional government and private efforts did not succeed because of a lack of community participation. Programme planners must involve the consumers in diagnosing these community characteristics and in planning, supervising and maintaining the resulting projects. The multi-strategy approach will help avoid wasted resources and false expectations that arise when project staff attempt to apply a "magic bullet" solution to a complex problem.

Original languageEnglish (US)
Pages (from-to)1319-1326
Number of pages8
JournalSocial Science and Medicine
Issue number12
StatePublished - 1991
Externally publishedYes


  • guineaworm
  • health education
  • multi-strategy
  • self-help

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science


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