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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Public Health Risk Analysis and Surveillance
Public Health Surveillance Protocol Tuberculosis
El propósito de este documento es presentar orientaciones para mejorar la aplicación de medidas de salud pública no farmacológicas durante la respuesta a la COVID-19, así como la adherencia a dichas medidas por parte de los grupos de población en situación de vulnerabilidad. Para ello, es nec...esario identificar los principales obstáculos a la aplicación de las medidas, lo que nos permite determinar los grupos y territorios más afectados en las diferentes fases de la pandemia. Con este objetivo, y desde un marco de equidad, derechos humanos y diversidad, se recomiendan políticas, estrategias e intervenciones que acompañan la aplicación y flexibilización de las medidas, de modo que nadie quede atrás.
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Community Health Volunteers
Encuesta Nacional de Condiciones de Vida 2015 (ENCOVI)
Standard Treatment Guideline
En esta obra se presentan mensajes básicos para pasar a la acción, resumidos
en una serie de capítulos sobre diversos temas ligados a la salud ambiental,
consultables en línea en: http://www.who.int/ceh/publications/hehc_booklet/en/
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ت، ّالرعاية الصحية المجتمعية، بما يتضم."19كوفيد-′′في سياق جائح