Health Policy Plan (2017) 32 (5): 603-612; 10 pp. 318 kB
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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This document is to guide policy makers, managers, districts, health workers, communities, NGOs and all other stakeholders on how to implement newborn health services.
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.
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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Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance
Physical distancing measures are important to reduce COVID-19 transmission. However, when stringently applied, they can result in negative health and socio-economic impacts. This report draws on a rapid review of available literature, case studies from across Africa and expert knowledge to make reco...mmendations on adapting classic physical distancing measures to the contextual realities in Africa and on mitigating potential negative impacts.
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To understand the patterns of Rwanda’s achievements in health development, it is important to explore how Rwanda addresses the Social Determinants of Health (SDH) particularly those related to routine conditions in which people are born, live and work. It is in this particular context that a case ...study on Rwanda’s Performance in Addressing Social Determinants of Health was conducted by the Rwanda Ministry of Health, with technical and financial support from the World Health Organization (WHO). The overall goal of the exercise was to document Rwanda's recent initiatives that contribute to the advancements of the Rio Political Declaration on Social Determinants of Health.
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This guidance document includes background information on Ebola virus disease, Ebola emergency committee recommendations, risks for different groups, and information for travellers from and to affected countries.
The "Primary Healthcare Standard Treatment Guidelines and Essential Medicines List" by the South African National Department of Health provides evidence-based guidelines for diagnosing and managing common medical conditions at the primary healthcare level. This document includes treatment protocols ...for various health issues, such as infections, chronic diseases, maternal and child health, mental health, and emergency care. It aims to standardize care, promote rational medicine use, and ensure equitable access to essential medications across South Africa. The guidelines emphasize prevention, accurate diagnosis, and efficient treatment strategies to improve patient outcomes.
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Health facilities in the Region of the Americas frequently suffer the effects of health emergencies and disasters, which jeopardize their ability to provide services to the population. The STAR-H methodology helps staff responsible for health emergency and disaster risk management to identify and as...sess risks as part of strategic planning to improve facility preparedness. It is intended to help them develop, with a multi-hazard approach, a response framework with operating procedures to deal with hazards of any type, scale, or frequency; determine roles and responsibilities; facilitate the effective use of resources; undertake strategic planning exercises, and improve the preparedness of facilities to effectively respond to and recover from impacts. This methodology is designed for use in health facilities of any size and capacity, and makes it possible to generate historical reports and national or subnational risk profiles. This information can be used to develop an effective health emergency and disaster risk management program.
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The revised guidelines present two major changes to existing guidelines: (A) there are now just 2 categories of pneumonia instead of 3 (“pneumonia” which is treated at home with oral amoxicillin and “severe pneumonia” which requires injectable antibiotics) and (B) oral amoxicillin replaces o...ral cotrimoxazole as first line treatment, preferably in 250mg dispersible tablet form, twice daily for five days which can be reduced to three days in low HIV settings.
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A Community Guide to Environmental Health > Chapter 19: Health Care Waste. Please download this chapter from the website of Hesperian
A systematic review informing a radical transformation of health workforce development