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
Jeder ehrenamtliche Helfer in und um Würzburg kann sich an Standpunkt e.V. wenden und kostenlos Skripte bekommen. Schreibt dazu bitte eine Mail an info@standpunkt-ev.de
https://doi.org/10.1016/j.vaccine.2019.09.099
The article "Economic burden of cholera in Asia" examines the financial impact of cholera in 14 Asian countries. It analyzes costs related to treatment, out-of-pocket expenses, and lost productivity due to illness and premature deaths. The study estimat...es that cholera caused approximately $41 million in direct costs and $946 million in lost productivity in 2015. It highlights the significant economic burden on public health systems and households, emphasizing the need for investments in cholera prevention, including improved sanitation, clean water access, and vaccination programs.
more
The article outlines the prioritized research agenda for the prevention and control of chronic respiratory diseases (CRDs) as part of the World Health Organization's (WHO) action plan on noncommunicable diseases (NCDs) from 2008 to 2013. It highlights the significant global impact of CRDs, including... asthma, chronic obstructive pulmonary disease (COPD), and other related conditions, particularly in low- and middle-income countries (LMICs). The document stresses the need for effective prevention strategies and better surveillance, as well as enhanced healthcare infrastructure and resources in LMICs. It calls for research into CRD risk factors, effective interventions, and integrated care approaches that align with broader NCD prevention programs. The article emphasizes the importance of public health initiatives and cross-sector collaborations to reduce the disease burden and improve patient outcomes.
more
DHS Further Analysis Reports No. 101
SUI supporting material
• Person stories
• Role plays
• Multiple choice questions
• Video link
Five years after a global commitment to Fast-Track the HIV response and end AIDS by 2030, the world is off track. A promise to build on the momentum created in the first decade of the twenty-first century by front-loading investment and accelerating HIV service provision has been fulfilled by too fe...w countries
more
Curr Psychiatry Rep. 2011 Dec;13(6):493-9. doi: 10.1007/s11920-011-0229-8.
Health Economics Review, 2016 6:7 -Published: 11 February 2016
แนวปฏิบัติในการจัดการความเสี่ยง ดานภาวะฉุกเฉินและความพิการเพื่อสุขภาพ
This new edition highlights once again the importance of collecting disaggregated data to conduct gender-based analysis in order to determine, address, reduce, and eliminate the causes of gender-related inequalities.