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This two-site randomised trial compared the effectiveness of a voluntary sector-led, community-based diabetes prevention programme to a waiting-list control group at 6 months, and included an observational follow-up of the intervention arm to 12 m
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onths.
more
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.
more
The article "Capacity-Building in Community-Based Drug Treatment Services" by Michael J. Cole focuses on the global challenges in providing adequate community-based drug treatment services. It highl
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ights the gaps in availability, quality, and accessibility of evidence-based care. The article discusses the principles and strategies for capacity-building at three levels: individual, organizational, and service sector. It emphasizes using an empowerment model, engaging community stakeholders, and creating sustainable practices. The paper also addresses the need for systematic planning, assessment, and collaboration to strengthen drug treatment systems globally.
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The Community-based Health System Model Series briefs identify and discuss critical health system inputs and processes that have contributed to the implementation and expansion of community-based se
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rvice delivery in different countries.
Countries were selected for their geographic diversity, type of service delivery model, and programmatic scale-up.
This brief reviews Malawi’s community health model to inform future policy, program design, and implementation in other countries.
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People living with disabilities (PLWDs) have poor access to health services compared to people without disabilities. As a result, PLWDs do not benefit from some of the services provided at health facilities; therefore, new methods need to be developed to deliver these services where PLWDs reside. Th
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is case study reports a household-based screening programme targeting PLWDs in a rural district in Malawi. Between March and November 2016, a household-based and integrated screening programme was conducted by community health workers, HIV testing counsellors and a clinic clerk. The programme provided integrated home-based screening for HIV, tuberculosis, hypertension and malnutrition for PLWDs. The programme was designed and implemented for a population of 37 000 people. A total of 449 PLWDs, with a median age of 26 years and about half of them women, were screened. Among the 404 PLWDs eligible for HIV testing, 399 (99%) agreed for HIV testing. Sixty-nine per cent of PLWDs tested for HIV had never previously been tested for HIV. Additionally, 14 patients self-reported to be HIV-positive and all but one were verified to be active in HIV care. A total of 192 of all eligible PLWDs above 18 years old were screened for hypertension, with 9% (n = 17) referred for further follow-up at the nearest facility. In addition, 274 and 371 PLWDs were screened for malnutrition and tuberculosis, respectively, with 6% (n = 18) of PLWDs referred for malnutrition, and 2% (n = 10) of PLWDs referred for tuberculosis testing. We successfully implemented an integrated home-based screening programme in rural Malawi.
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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 Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi
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(TIKA) for urban population since 2009. This study investigated the implementation of TIKA scheme in urban districts of Tanzania.
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‘Do not underestimate the capacity of the community; they are smarter and more capable than you think’
Building Capacity for Disability Inclusion in Gender-based Violence (GBV) Programming in Humanitarian Settings
recommended
Leora Ward, Emma Pearce, Dale Buscher et al.
Women’s Refugee Commission (WRC) and The International Rescue Committee (IRC)
(2015)
C1
Women and girls with mental and intellectual disabilities were perceived to be most at risk of sexual violence, and family and service providers may only become aware of sexual violence against them when they become pregnant.
Discrimination by GBV service providers, family and community members was
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the most common barrier to access. Inadequate transportation and inappropriate communication approaches were also common impediments.
On this website you can download the report in different languages,
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Lancet Glob Health 2015; 385: e387–95. Open Access
The guide summarizes an assessment of War Child Canada’s three-pronged legal protection model as implemented with South Sudanese refugees in Northern Uganda and uses it to identify the most important lessons for ensuring legal protection mechanisms are in place at the onset of an emergency
Family Planning Realities Among Faith-Based Medical Bureaus in Uganda
Laura Wando, MPH; Amy Metzger, MPH; Douglas Huber, MD, MSc; Judith Brown, PhD; Moses Muwonge, MD
Christian Connections for International Health (CCIH), USAID
(2013)
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Christian Connections for International Health (CCIH), a U.S.-
based nonprofit membership organization commissioned a
Family Planning (FP) survey of faith-based facility-
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based private
not-for-profit (FB-PNFP) health facilities in Uganda in 2013.
Country-wide health facilities of the Uganda Orthodox Church
Medical Bureau (UOMB), the Uganda Muslim Medical Bureau
(UMMB), the Uganda Catholic Medical Bureau (UCMB), and the
Uganda Protestant Medical Bureau (UPMB) were contacted by
phone and interviewed with established questions related to
family planning, contraceptive security, maternal and newborn
health.
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BMC International Health and Human Rights 2012, 12 :12
http://www.biomedcentral.com/1472-698X/12/12
