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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Men lag behind women regarding use of HIV services and represent the majority of individuals living with uncontrolled HIV, advanced HIV, and who experience HIV-related mortality. Men (15+) globally are less likely than women (15+) to know their HIV status (83% for men vs 91% for women), be on antire...troviral treatment (ART) (72% for men vs 83% for women) and reach viral suppression (67% for men vs 78% for women).
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Case Studies on Building Resilience in the Horn of Africa
Facilitator's Manual on life Skill Education, Stress Management and Suicide Prevention Workshops
Strengthening competency based training of health care providers for Reproductive Maternal Newborn Child & Adolescenct Health (RMNCH + A) services
Each year, dozens of communities around the world face natural disasters, disease outbreaks, and other emergencies. Scientists think that a worldwide influenza outbreak will happen sometime in the next decade. The purpose of this guide is to help local leaders and community organizers bring together... the community to help plan for disease outbreaks and other emergencies. This guide uses the lessons from communities that have already dealt with disease outbreaks and also uses other often-used tools to create discussion among community members and effectively garner their insight
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Clinical Infectious Diseases
1586 - 1594 • CID 2016:62 (15 June) • HIV/AIDS
Biology, Diagnosis and Treatment, Epidemiology and Prevention
Mental illness can affect not only the life of the person with the illness, but also their close family, partners
and friends. Significant people in a person’s life are often a source of support with the illness.
However, family, partners and friends may be faced with a loved one’s men...tal illness without much
information on ways to deal with it and its impact on their life.
NOTE: This guide is NOT a replacement for medical advice and we strongly recommend that you or the person you care
for discuss issues related to treatment with a clinician.
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