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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South Eastern European Journal of Public Health, EEJPH 2016, posted: 11 January 2016. DOI 10.4119/UNIBI/SEEJPH-2016-85
Heart failure (HF) is a global public health concern with disproportionate socioeconomic, morbidity and mortality burden on low- and middle-income countries (LMICs). This review summarises contemporary data on the demographic and clinical characteristics, aetiologies, treatment, economic burden and ...outcomes of HF in LMICs. Patients with HF in LMICs are younger than those from high-income countries (HICs) and present at advanced stages of the disease. Hypertension, ischaemic heart disease (IHD), cardiomyopathy (CMO), and rheumatic heart disease (RHD) are the leading causes of HF in LMICs. The contribution of infectious diseases to HF remains prominent in many LMICs. Most health facilities in LMICs lack adequate diagnostic tools for HF, and the use of evidence-based medical and device therapies is suboptimal. Further, HF in LMICs is associated with prolonged hospital stay and high in-hospital and one-year mortality. Finally, HF has profound economic impact on individual patients who, mostly, have no health insurance, and on societies where patients are young, comprising those who have the greatest potential to contribute to economic productivity.
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British Journal of Medicine & Medical Research
11(4): 1-6, 2016, Article no.BJMMR.21444
ISSN: 2231-0614, NLM ID: 101570965
Published 27th September 2015
From raising awareness to building capacity
Meeting Report
World Health Organization, Geneva, Switzerland 16 -18 September 2013
Despite recent global declines, under-five mortality remains high in many of the poorest countries. Barriers to timely
quality care, including user fees, distance to facilities and the availability of trained health workers and medical supplies,
hinder progress in further reducing morbidity and m...ortality
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The Government of Malawi’s Health Sector Strategic Plan II highlights the importance of service integration; however, in practice, this has not been fully realized. We conducted a mixed methods evaluation of efforts to systematically implement integrated family planning and immunization services i...n all health facilities and associated community sites in Ntchisi and Dowa districts during June 2016–September 2017. Methods included secondary analysis of service statistics (pre- and postintervention), focus group discussions with mothers and fathers of children under age one, and in-depth interviews with service providers, supervisors, and managers. Results indicate statistically significant increases in family planning users and shifts in use of family planning services from health facilities to community sites. The intervention had no effect on immunization doses administered or dropout rates. According to mothers and fathers, benefits of service integration included time savings, convenience, and improved understanding of services. Provision and use of integrated services were affected by availability of human resources and commodities, community linkages, data collection procedures and availability, sociocultural barriers, organization of services, and supervision and commitment of health surveillance assistants. The integration approach was perceived to be feasible and beneficial by clients and providers.
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Nested case-control study of health workers exposed to confirmed COVID-19 patients.
Similar objectives to the cohort study but case-control studies may be cheaper and provide robust evidence to characterize and assess the risk factors for SARS-CoV-2 infection in health workers exposed to COVID-19 p...atients.
Health workers with confirmed COVID-19 will be recruited as cases and other health workers in the same health care setting without infection will be recruited as controls (incidence density sampling).
Secondary objectives are similar to the cohort study.
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A MANUAL FOR WASH IMPLEMENTERS, BOTSWANA
Sightsavers | Department for International Development | The International Trachoma Initiative | Children Without Worms | WaterAid | WASH Advocates | Center for Global Safe Water, Emory University | CARE USA
CBR Advisory Working Group | Co-ordinator: Karen Heinicke-Motsch
This manual is intended to enable WASH practitioners
who work in Mozambique to contribute to the
reduction of WASH-preventable NTDs.
The Democratic Republic of the Congo (DRC) is one of the most complex and long-standing humanitarian crises in Africa. By the end of 2020, some 940,421 Congolese refugees and asylum seekers were hosted across the African continent. Ongoing conflicts in eastern DRC, as well as intercommunal violence,... continue to cause forced displacement within the DRC and into neighbouring countries, along with tragic loss of human life and destruction of communities.
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In 2017, the World Bank and partners created the Global Investment Framework for Nutrition as a roadmap towards achieving the World Health Assembly (WHA) nutrition targets by 2025. The framework estimates that the world needs to mobilize an annual additional investment of $7 billion per year to scal...e-up nutrition-specific interventions at the level needed to achieve the global targets. However, the world is off-track to meet the global targets. And it is unclear whether additional resources will be mobilized for life-saving and cost-effective nutrition-specific interventions, or whether donor support will be enough to meet the annual resource need established by the framework.
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The World health statistics report is the annual compilation of health and health-related indicators which has been published by the World Health Organization (WHO) since 2005. The 2023 edition reviews more than 50 health-related indicators from the Sustainable Development Goals (SDGs) and WHO’s T...hirteenth General Programme of Work (GPW 13).
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