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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 disease-specific outcomes
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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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The role of community health workers in the re-engineering of primary health care in rural Eastern Cape
Karl le Roux, Ingrid M le Roux, Nokwanele Mbewu & Emily Davis
South African Family Practice
(2015)
CC
Countries must invest at least 1% more of GDP on primary health care to eliminate glaring coverage gaps
At current rates of progress up to 5 billion people will miss out on health care in 2030
C
...
ountries must increase spending on primary healthcare by at least 1% of their gross domestic product (GDP) if the world is to close glaring coverage gaps and meet health targets agreed in 2015, says this new report. They must also intensify efforts to expand services countrywide.
The world will need to double health coverage between now and 2030, according to the Universal Health Coverage Monitoring Report. It warns that if current trends continue, up to 5 billion people will still be unable to access health care in 2030 – the deadline world leaders have set for achieving universal health coverage. Most of those people are poor and already disadvantaged.
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This manual is about the basic nursing care - desinfection, cleaning, sterilization, nursing documentation, hygiene, surgical care and preparation and much more. This booklet has been prepared by th
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e NED Volunteers Foundation.
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BMC Family Practice201415:165, DOI: 10.1186/1471-2296-15-165
Open Access
Attraction and Retention of Rural Primary Health-care Workers in the Asia Pacific Region
Liu Xiaoyun; Zhu, Anna; Tang, Shenglan
World Health Organization, Regional Office for South-East Asia
(2018)
C_WHO
The Asia Pacific Observatory on Health Systems and Policies is a collaborative partnership which supports and promotes evidence-based health policy making in the Asia Pacific Region. Based in WHO’s Regional Office for South-East Asia, it brings together governments, international agencies, foundat
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ions, civil society and the research community with the aim of linking systematic and scientific analysis of health systems in the Asia Pacific Region with the decision-makers who shape policy and practice.
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Clincial Practice Guidelines
Chapter 10 of Pediatric Surgery: This chapter provides an overview of some of the challenges when providing anaesthesia care for children in Africa. The chapter reviews
the cardiac, respiratory, and renal differences of children in comparison to ad
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ults. Additionally, it addresses preoperative assessment, including guidelines for nothing by mouth (NPO, or nil per os), general and regional anaesthesia, intraoperative monitoring, airway management, and postoperative care
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Published: February 23, 2010
https://doi.org/10.1371/journal.pmed.1000235
Volume 7 | Issue 2 | e1000235
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,
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hinder progress in further reducing morbidity and mortality
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In this paper we aim to provide information on the importance of efficiency measurement of health care facilities in developing countries. We state that efficiency measurement can be a substantial contribution to saving lives. Therefore we analyse t
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he performance of health centres in rural Burkina Faso making use of data which were taken from a comprehensive long-term cost information system. In the subsequent parts of this article, the study site is described and the DEA method outlined. The ensuing analysis of the data is carried out in two stages. Firstly, quantitative aspects concerning relative efficiency are presented. Secondly, the measures of performance are explained. The implications of the results are then discussed.
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Evaluating the Return on Investment of Scaling Up Treatment for Depression, Anxiety, and Psychosis
Mental health is critical to personal well-being, interpersonal relationships, and successful contributions to society. Mental health conditions consequently impose a high burden not only on individuals, families and society, but also on economies. In Jamaica, mental health conditions are highly pre
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valent and major contributors to morbidity, disability, and premature mortality.
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Being a caregiver can be an exhausting and difficult task. It’s important to recognize caregiver burnout and cope healthily. Understanding caregiver burnout symptoms and coping mechanisms can help make caregiving more enjoyable and fulfilling.About 1 in 3 adults serves as an informal caregiver to
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another adult, like an aging parent or disabled relative. Although many find the opportunity to care for a loved one to be a privilege, it can also be demanding. Here is how to cope effectively.
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Essential Skills for Mental Health Care
recommended
Providing financial protection to the population for larger health care expenses arising out of hospital-based care, has come forth as a crucial element in the attainment of Universal Health Coverag
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e (UHC) through the recent health financing reforms of low-and middle-income countries (LMIC). Over the last decade, the state of Assam in India, in an effort to ensure equitable health care access, has formulated multiple health protection schemes at different points of time. This has resulted in several such schemas which have had their own objectives, designs, institutional setups, and governance mechanisms. Moreover, they have reportedly been operating in relative silos.
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Solidarity” is an international clinical trial to help find an effective treatment for COVID-19, launched by the World Health Organization and partners.
The Solidarity Trial will compare four treatment options against standard of care, to asses
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s their relative effectiveness against COVID-19. By enrolling patients in multiple countries, the Solidarity Trial aims to rapidly discover whether any of the drugs slow disease progression or improve survival. Other drugs can be added based on emerging evidence.
Until there is sufficient evidence, WHO cautions against physicians and medical associations recommending or administering these unproven treatments to patients with COVID-19 or people self-medicating with them. WHO is concerned by reports of individuals self-medicating with chloroquine and causing themselves serious harm.
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