An urban context has its similarities and differences from the rural one. Some learned lessons from the Urban Maroua District (Extreme North Region) of Cameroun and wise advices from experienced colleagues can be shared:

-         As indicated by experiences the third stage usually needs a door to door screening. This is due to the of information asymmetry that is typical in urban households (they do not have perfect information about all the children in their vicinity as rural clusters do). As Melaku cleverly explained. -         Door to door screening can be very time consuming. To save time and energy is important to understand door to door is not the same as mass screening. You do not need to screen every child behind every door. The difference from the active case finding approach is merely that you ask people as you move from door to door whether they know such cases. Also, you do not have to knock on every door: whereas people don’t know everyone in their neighborhood, they often will know if the children in the house next door are sick. Therefore you can only cover "clusters" of houses, rather than every house. urban setting - ines   -         Having a lot of really small teams (1-2) may be preferable in this case. The key is to give them each a fairly clearly defined area that ensures there are no pockets left, but also little/no overlap. Two practical recommendations from Saul and Uwimana. -         Sometimes the size of administrative sectors in urban areas is too high. And a good idea could be the segmentation. The chosen sector will be segmented into equal parts (2 or 3 or 4 depending on the size) and randomly sample one sub sector from the four segments and do the active case finding on it using house to house screening. But, it is important to ensure that sufficient number of sectors or segments of sectors are done to reach the minimum SAM number required. A positive point of the urban context (at least in Urban Maroua) was the easier management of the logistics in relation to the rural context. No nights are needed to be spent out in the field to reach far villages or health facilities. And taxis can be used for the team’s displacement (offering the possibility of reducing the cost of car rental).

One comment on “Experiences from an urban SQUEAC

  1. CHI Canada says:

    I like it. Thanks

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