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This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community 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 cha
...
llenge 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.
more
This publication provides managers with guidance on how to create basic HIV prevention cascades as a starting point to enhance their ability to monitor and improve their programming and to facilitate comparisons of programme effectiveness across sites.
This document synthesizes key elements of the World Health Organization (WHO) normative guidance on health policy and system support for community health worker (CHW) programmes and their application for HIV programmes. Building on relevant elements of HIV guidelines, tools and evidence identified b
...
y experts, it provides recommendations on tasks and roles that can be performed by CHWs (including for HIV), identifies the policy and system supports to optimize CHW performance, and gives examples of best practice. Its purpose is to inform the optimal design and delivery of CHW programmes targeting – either specifically or as part of a broader approach – the scale-up and sustainability of HIV services.
more
The Essential Nutrition Actions and Essential Hygiene Actions Training Guide: Community Workers strengthens the capacity of community workers to deliver and promote the essential nutrition and hygiene actions. It introduces technical content within hands-on sessions to practice counseling and negoti
...
ation, using role plays and field practice. It guides community workers in understanding why and how to integrate messages on nutrition and hygiene into their different program platforms using a life cycle approach to deliver the right message to right person at the right time.
more
INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat
...
e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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RESULTS: Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. Dur
...
ing the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients' utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19.
CONCLUSIONS: The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.
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These guidelines provide a framework for effective action to facilitate access to safe and ethical
testing services for different population groups. The implementation of the a comprehensive
approach, known as HIV Testing Services (HTS) is cardinal as an effective package of services
that diminis
...
hes the impact of the HIV epidemic in our country. All forms of HTS adhere to
the 5Cs: Confidentiality, Counselling, Consent, Correct results and Connection, or linkage
to care, with all based within a human right context. In addition to the 5Cs, however, the
MOHCDGEC emphasizes the use of a variety of approaches to HTS that will reduce the
number of missed opportunities. These include Provider-Initiated Testing and Counselling
testing, Couple counselling and testing, Index testing, and infant and children counselling and
testing in alignment to the revised WHO guidelines. Furthermore, these guidelines accentuate
on the continual provision of integrated HTS service at all levels of the public and private
health service delivery system.
The HTS Providers, managers and other stakeholders
more
To support countries in adapting their response to different COVID-19 scenarios, the World Health
Organization (WHO) Department of Maternal, Newborn, Child and Adolescent Health and Ageing commissioned this scoping review of published and grey literature. The objective was to identify interventions
...
implemented to maintain the provision and use of essential services for MNCAAH during disruptive events and to summarize lessons learned during these interventions. The review included outbreaks of Ebola virus disease (EVD), severe acute respiratory syndrome (SARS), Zika virus disease (ZVD), the ongoing COVID-19 pandemic, and natural disasters and humanitarian emergencies that caused disruption to services, transport and other activities.
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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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Low- and middle-income countries (LMICs) experience a high disease burden for epilepsy, a chronic neurological condition.The authors evaluate the cost-effectiveness of community health workers (CHWs) to improve adherence to medication for epilepsy in South Africa. They found that utilizing CHWs to i
...
mprove medication adherence was cost-effective.
more
Mohamed et al. BMC Public Health 2018, 18(Suppl 3):1215
https://doi.org/10.1186/s12889-018-6053-xpre-
One of the many gender inequities in the health and care workforce that COVID-19 has exposed is around the fit and design of Personal Protective Equipment (PPE). The rapid onset and scale of COVID-19 led to shortages of PPE in most countries, causing preventable infection and mortality among healthc
...
are workers and others on the front lines. Even though most health workers are women, manufacturing specifications for medical PPE are usually drawn up based on the male body and there have been many reports of PPE not designed for women's bodies.
more
The Lancet. 13 March 2022. doi: 10.1016/S0140-6736(21)02868-3. Previous Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) studies have reported
national health estimates for Ethiopia. Substantial regional variations in socioeconomic status, population, demography, and access to hea
...
lth care within Ethiopia require comparable estimates at the subnational level. The GBD 2019 Ethiopia subnational analysis aimed to measure the progress and disparities in health across nine regions and two chartered cities.
more
The climate crisis has many consequences – among them widespread health impacts that will lead to immense societal, ecological, and economic harm.
Over the past two decades multiple large-scale reviews on climate change and health have made clear the need for a multi-sectoral approach to target t
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he drivers and impacts of climate change, biodiversity loss, and ecosystem degradation. Despite this abundance of scientific evidence underscoring urgency of action, policy implementation responses lag behind. Even at COP26, itself delayed due to an ongoing pandemic, health continues to be considered by many countries a problem independent from climate and environment.
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An interdisciplinary study within the framework of the dialogue project on the contribution of the Catholic Church to a socio-ecological transformation.
The study examines the obstacles to the implementation of the socio-ecological transformation and develops recommendations for action.
Project Drawdown (2022) provides evidence of how climate solutions can also be win-win opportunities for meeting development and human well-being needs while boosting prosperity for rural communities in sub-Saharan Africa and South Asia. The report summarizes the co-benefits of five groups of a subs
...
et of Project Drawdown climate solutions (28 total solutions) for advancing human well-being in rural areas of low- and middle-income countries
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This guideline aims to improve the quality of essential, routine postnatal care for women and newborns with the ultimate goal of improving maternal and newborn health and well-being. It recognizes a “positive postnatal experience” as a significant end point for all women giving birth and their n
...
ewborns, laying the platform for improved short- and long-term health and well-being. A positive postnatal experience is defined as one in which women, newborns, partners, parents, caregivers and families receive information, reassurance and support in a consistent manner from motivated health workers; where a resourced and flexible health system recognizes the needs of women and babies, and respects their cultural context.
This is a consolidated guideline of new and existing recommendations on routine postnatal care for women and newborns receiving facility- or community-based postnatal care in any resource setting.
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