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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Updated on 6 APRIL 2020
There are serious concerns that the situation might escalate in the next weeks modelling the epi curve of other regions. The interlinkages between human mobility and the current pandemic of COVID-19 are well established, and while international flights have been suspended i...n the region, the porous borders on land and water crossings remain difficult to control.
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Health Economics Review, 2016 6:7 -Published: 11 February 2016
front cover © Hannah Maule-Ffinch/Save the Children
Biology, Diagnosis and Treatment, Epidemiology and Prevention
Participatory Learning and Action Planning; A Facilitator's Guide
Note d’orientation | 16 March 2020
Ne pas causer de dommages, égalité, transparence et humanité - Les valeurs directrices pour guider la réponse de la justice pénale au Coronavirus
Au moment de la publication de cette note d’orientation, plus de 164’000 cas* de COVID-19, cette nouvell...e forme du coronavirus, avaient été enregistrés dans 100 pays, avec plus de 6’470 décès. Le présent document examine la situation en ce qui concerne les foyers d’infection au COVID-19 et les mesures de prévention dans les prisons**, ainsi que l’impact des réponses générales apportées par des gouvernements pour lutter contre la pandémie sur les personnes dans le système de justice pénale. Cette note d’orientation plaide pour une action immédiate au vu des risques auxquels sont exposés les personnes en milieu carcéral, y compris le personnel pénitentiaire.
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Le Burkina Faso est un pays sahélien sans littoral d’une superficie de 274 000 km2 et une
population estimée à 17,4 millions d’habitants en 2013 avec une croissance démographique de
3,1%. C’est l’un des pays les plus pauvres du monde avec un Produit intérieur brut par tête de
684 US...$ (Banque Mondiale, 2013), un indice de développement humain (IDH) de 0,388 et une
incidence de la pauvreté de 46,7% (INSD, 2009). Environ 80% de la population vit directement
ou indirectement de l’agriculture de subsistance au gré des aléas climatiques.
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В настоящем документе представлен первоначальный обзор поступающей информации
(по состоянию на 2 июля 2020 г.) о взаимосвязи между COVID-19, НИЗ и факторами
риска НИЗ. Ре...цензируемые статьи взяты из баз данных NCBI PubMed, PMC и Google
Scholar. Данный обзор свидетельствует о том, что лица, живущие с НИЗ, подвержены
более высокому риску развития тяжелого заболевания и смерти в связи с COVID-19,
и об ограниченности данных для оценки риска. Наряду с этим в нем обобщаются
результаты двух проведенных ВОЗ обследований, указывающих на то, что с началом
пандемии была серьезно нарушена система предоставления услуг по профилактике и
лечению НИЗ.
Response to non-communicable diseases during and after the COVID-19 pandemic
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The paper provides the rationale for these recommendations, which are based on analyses of data from the TRACT trial.