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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The limitation of a single sector approach. HNP Discussion Paper
Handout presentations in PDF for illustrating lectures
Accessed May 2014
The purpose of the review was to assign a cause of death, to ascertain the fac-tors that contributed to the death and to identify any systemic issues that could be addressed to prevent future similar deaths. The perinatal mortality audit process in 2019 provided important insights and evidence-based... recommendations that can be used both to address system errors and barriers and to identify and praise points of strength. The aim is to pro-vide recommendations for better care for mothers and their infants during pregnancy, childbirth and the neonatal period and improve the quality of care provided throughout the health system.
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abridged version, March 2021
he study highlights the impacts of COVID-19 on women and men as gleaned from research conducted during 2020, as well as the Computer Assisted Telephonic Interviews (CATI) Rapid Gender Assessments (RGAs) executed by UN Women, UNFPA and partners in seven countries in the ...East and Southern Africa region.
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Целью этой главы является представление ключевых элементов, касающихся терапевтического использования психотропных лекарственных средств у детей и подростков, ... также знакомство
клиницистов с общими принципами фармакотерапии психиатрических расстройств в период развития. Для более детального ознакомления со специфическими медикаментами мы рекомендуем читателям обратиться к соответствующим главам, посвященным конкретным расстройствам.
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For the Assesor's Guide Vol 1 and 2 see: nrhm.gov.in/images/pdf/programmes/maternal-health/guidelines/Operational_Guidelines_for_Quality_Assurance_in_Public_Health_Facilities_and_checklists-3_books.zip
This report provides a review and analysis of the research landscape for three diseases – Chagas disease, human African trypanosomiasis and leishmaniasis – that disproportionately afflict poor and remote populations with limited access to health services. It represents the work of the disease re...ference group on Chagas Disease, Human African Trypanosomiasis and Leishmaniasis (DRG3) which was established to identify key research priorities through review of research evidence and input from stakeholders' consultations.
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Arq Neuropsiquiatr 2011;69(2-B):342-348