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.
more
Externalising disorders
Chapter D.3
Promoting People's Health to Enhance Social-economic Development
PLoS Med. 2009 Oct;6(10):e1000159. doi: 10.1371/journal.pmed.1000159. Epub 2009 Oct 6.
A resource for pesticide registrars and regulators.
The WHO urged governments to restrict access to highly toxic pesticides used for self-poisoning . Other effective interventions include education, youth intervention programs and follow-up of people at risk—and better data. Only 80 out of 183 WH...O member states reported high-quality vital registration data in 2016
more
The objectives of the research presented in this report were to identify case studies of community-led HIV-related health and social inclusion service delivery organizations in eastern and southern Africa; describe the typologies of the services provided; and identify evidence of their service deliv...ery and contribution beyond HIV, including advancing universal health coverage.
more
Practical Guide on Trauma-Informed Approaches
WHO has published the first-ever guidance on the clinical management of diphtheria. The only previously available guidance was an operational protocol. The new guidance followed the rigorous process for developing guidance at WHO.
It addresses the use of Diphtheria Antitoxin (DAT) in the treatmen...t of diphtheria. There is a worldwide shortage of DAT and evidence based recommendations on the use of DAT were requested by many Member States.
The guidance also includes new recommendations on antibiotics. In patients with suspected or confirmed diphtheria, WHO recommends using macrolide antibiotics (azithromycin, erythromycin) rather than penicillin antibiotics.
This clinical practice guideline has been rapidly developed recognizing the global increase in diphtheria outbreaks. Outbreaks of diphtheria in Nigeria, Guinea and neighbouring countries in 2023 have highlighted the urgent need for evidence-based clinical practice guidelines for the treatment of diphtheria. Given the sporadic nature of outbreaks, many clinicians in the affected regions have never managed acute diphtheria and its related complications. Diphtheria remains a neglected disease and vaccination is the top priority. At the same time, for patients with diphtheria, access to antibiotics, DAT and supportive care can be lifesaving.
more
Emergency medical teams (EMTs) play an important role in strengthening health service networks in terms of their strategies and tactics for planning mass vaccination programs, especially in remote or under-resourced areas or those overwhelmed by COVID-19. EMTs experience deploying in remote areas an...d handling operational challenges to ensure their response even under the most austere conditions will be of great support in facing the technical and logistical challenges to timely and equitable access to vaccines at the local level.
more
July 2018
This fourth edition of the Unitaid/WHO market and technology landscape: HIV rapid diagnostic tests for self-testing report summarizes the current HIV testing gap; the challenges facing efforts to scale up; and the potential role HIV self-testing (HIVST) could play to achieve the United... Nation’s 90-90-90 targets. In particular, the report synthesises the existing and emerging market demand and supply of kits.
The information in this report is intended for manufacturers, donors, national programmes, researchers and other global health stakeholders who are exploring the potential role of HIVST.
more
The new WHO recommendations for the treatment of isoniazid-resistant, rifampicin-susceptible TB are based upon a review of evidence from patients treated with such regimens by a Guideline Development Group in conformity with WHO requirements for evidence-based policies.
A Public Health EOC (PHEOC) serves as a hub for coordinating the preparation for, response to, and recovery from public health emergencies. The preparation includes planning, such as risk and resource mapping, development of plans and procedures, and training and exercising. The response includes al...l activities related to investigation, response and recovery. The PHEOC also serves as a hub for coordinating resources and information to support response actions during a public health emergency and enhances communication and collaboration among relevant stakeholders.
more
This manual aims to provide practical guidance to field workers in order to maximise the nutritional impact of food security & livelihoods (FSL) interventions. This requires the systematic use of a ‘nutrition lens’ at each step of the project cycle and a close collaboration between sectors.
Health Services Insights Volume 10: 1–7