Human Resources for Health201816:49; https://doi.org/10.1186/s12960-018-0315-7
Supportive supervision is considered critical to community health worker programme performance, but there is relatively little understanding of how... it can be sustainably done at scale. Supportive supervision is a holistic concept that encompasses three key functions: management (ensuring performance), education (promoting development) and support (responding to needs and problems). Drawing on the experiences of the ward-based outreach team (WBOT) strategy, South Africa’s national community health worker (CHW) programme, this paper explores and describes approaches to supportive supervision in policy and programme guidelines and how these are implemented in supervision practices in the North West Province, an early adopter of the WBOT strategy. Outreach teams typically consist of six CHWs plus a nurse outreach team leader (OTL).
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting th...eir effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expanding 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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PLoS Med 16(3): e1002768. https://doi.org/10.1371/journal.pmed.1002768
Home delivery and late and infrequent attendance at antenatal care (ANC) are responsible for substantial avoidable maternal and pediatric morbidity and mortality in sub-Saharan Africa. This cluster-randomized trial aimed to de...termine the impact of a community health worker (CHW) intervention on the proportion of women who visit ANC fewer than 4 times during their pregnancy and deliver at home.
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Acclerating attainment of universal health coverage and bridging the access inequity gap
With hundreds of illustrations and clear instructions, A Community Guide to Environmental Health helps health promoters, development workers, envir...onmental activists, and community leaders take charge of their environmental health in villages and cities alike. Also available in Arabic, Spanish, Chinese, Portuguese, Turkish, Dari, Malayan, Mongolian and Russian.
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This Policy for community-based health insurance answers the will of the Rwandan government to popularize the fundamental aces of the current policy. This document serves as an update to the first p...olicy that was elaborated and published in 2004, and integrates all the changes that have occurred in the process since then. This new version of the policy for community based health insurance contributes to the fulfillment of the same objectives as the EDPRS and the Millennium Development Goals (MDG). It integrates system experiences but more especially the devices adapted to the challenges with which community base health insurance are confronted at present.
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Dziva Chikwari et al. Implementation Science (2018) 13:70 https://doi.org/10.1186/s13012-018-0762-5
The harmonized training package for Point-of-use-fortification using micronutrient powders has been developed to guide in training frontline health workers. The micronutrient powders will be distributed at the ...box">health facilities where instructions on use will be provided by Health Care Providers. Community Health Volunteers will educate, counsel, and mobilize caregivers at the community level to visit health facilities for nutrition assessment and provision of the micronutrient powders.
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Community health worker teams are potential game-changers in ensuring access to care in vulnerable communities. Who are they? What do they actually do? Can they help South Africa realize universal <...span class="attribute-to-highlight medbox">health coverage? As the proactive arm of the health services, community health workers teams provide household and community education, early screening, tracing and referrals for a range of health and social services. There is little local or global evidence on the household services provided by such teams, beyond specific disease-oriented activities such as for HIV and TB. This paper seeks to address this gap.
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Shortages of healthcare workers is detrimental to the health of communities, especially children. This paper describes the process of capacity building Community ...medbox">Health Volunteers (CHVs) to deliver integrated preventive and curative package of care of services to manage common childhood illness in hard-to-reach communities in Bondo Subcounty, Kenya
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The COVID-19 pandemic is challenging health systems across the world. Rapidly increasing demand for care of people with COVID-19 is compounded by fear, misinformation and limitations on the movement of people and supplies that disrupt the delivery o...f frontline health care for all people...
This guidance addresses the specific role of community-based health care in the pandemic context and outlines the adaptations needed to keep people safe, maintain continuity of essential services and ensure an effective response to COVID-19. It is intended for decision-makers and managers at the national and subnational levels and complements a range of other guidance, including that on priority public health interventions, facility-based care, and risk communication and community engagement in the setting of the COVID-19 pandemic.
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This report makes the case for a major new initiative—to rapidly recruit, train and deploy 2 million community health workers in Africa. Drawing on a vast body of evidence and substantial regional... experience, the report shows how community health workers save lives and improve quality of life and how investments in community health workers effectively harness the demographic dividend, reduce gender inequality and accelerate economic growth and development. Indeed, the benefits of community health workers stretch from one end of the Agenda for Sustainable Development to the other.
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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 mortality
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