Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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Men lag behind women regarding use of HIV services and represent the majority of individuals living with uncontrolled HIV, advanced HIV, and who experience HIV-related mortality. Men (15+) globally are less likely than women (15+) to know their HIV status (83% for men vs 91% for women), be on antire...troviral treatment (ART) (72% for men vs 83% for women) and reach viral suppression (67% for men vs 78% for women).
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Guidance
Second Edition
Monitoring and Evaluation
Recovery from COVID-19 has been challenging in Guatemala. As a result of the prolonged socio-economic impact of the pandemic, the average poverty rate nationwide has increased by almost 5%. This rise in the poverty level further exacerbates preexisting vulnerabilities and erodes the limited safety n...ets available to vulnerable populations. Year after year, recurrent disasters and humanitarian crises aggravate the historic social gaps that result in high levels of vulnerability, multidimensional poverty, and overall deprivation of essential services among hundreds of thousands of Guatemalans. According to the World Risk Report 2020, Guatemala is the tenth country with the highest level of exposure to disaster worldwide. Globally, it ranks 28th regarding vulnerability according to the 2021 INFORM’s risk index and 62nd in the Global Climate Risk Index 2021.
In 2020, Guatemala faced a record-breaking and devastating hurricane season with extreme rainfall, catastrophic winds, and deadly landslides, from which the country has not yet recovered. Unfortunately, recurrent extreme weather events, such as Hurricane Julia that hit Central America in early October 2022, progressively but deeply eroded a weak health infrastructure and local health systems.
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Externalising disorders
Chapter D.3
This document is an evidence-based policy for the implementation of sound tuberculosis (TB) infection control by all stake- holders. It recommends a combination of measures aimed at reducing the risk of TB transmission within populations. The emphasis is on early and rapid diagnosis, and proper mana...gement of TB patients.
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The COVID-19 pandemic is having far reaching impacts, well beyond the health crisis and needs, with the most severe impacts experienced in the poorest countries and those most vulnerable to humanitarian crises including natural disasters, such as Nepal.
Q12. SCOPING QUESTION: In people with psychotic disorders, including schizophrenia and bipolar disorder, are recovery-oriented strategies enhancing vocational and economic inclusion (such as supported employment) feasible and effective?
Bulletin of the World Health Organization 2016. doi: http://dx.doi.org/10.2471/BLT.16.171082
Objective: To describe the temporal and geographical distribution of Zika virus infection, and associated neurological disorders, from 1947 to February 2016.
Working Document, September 2017
Euro Surveill. 2016;21(12):pii=30174. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.12.30174
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