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This article describes a Community-Based Participatory Approach (CBPA) for children with intellectual disability in Endosulfan affected areas of Kasaragod district in Kerala state of India. The CBPA strate
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gy evolved from Community Based Rehabilitation (CBR) and was led by Local Self-Government (LSG) members. It involves a four-pronged approach encompassing family, community, service centres and LSG, with a focus on income generation activities and creation of employment opportunities. The CBPA model considers the cultural
uniqueness and limited resources in areas where the unscientific and extensive use of pesticides has led to high prevalence of multiple deformities including intellectual disabilities.
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Equity and Quality in Health: a People's Right
Acclerating attainment of universal health coverage and bridging the access inequity gap
This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community
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health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major challenge in large-scale CHW programmes is the need for CHWs to establish and maintain benefcial relationships with both sets of actors, who may have diferent expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities.
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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
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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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This policy brief aims to provide a review of the current progress on implementing the Kenya national action plan on AMR, identifies critical gaps, and highlights findings to accelerate further progress in the human
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health sector. The target audience includes all those concerned with implementing actions to combat antimicrobial resistance in Kenya.
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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 d
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isease-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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Globally, there is increased advocacy for community-based health insurance (CBHI) schemes. Like other low and middle-income countries (LMICs), Tanzania officially established the
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Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi (TIKA) for urban population since 2009. This study investigated the implementation of TIKA scheme in urban districts of Tanzania.
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