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
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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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Today there are Community-based Rehabilitation (CBR) programmes in a large number of countries. In many countries, the CBR approach is a part of the natio
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nal rehabilitation services. However, there is a lack of reliable data about persons with disabilities who benefit from CBR and the kind of benefits they receive. This article reviews the disability data collection systems and presents some case studies to understand the influence of operational factors on data collection in the CBR programmes. The review shows that most CBR programmes use a variable number of broad functional categories to collect information about persons with disabilities, combined occasionally with more specific diagnostic categories. This categorisation is influenced by local contexts and operational factors, including the limitations of human and material resources available for its implementation, making it difficult to have comparable CBR data. Therefore, any strategies to strengthen the data collection in CBR programmes must take these operational factors into account.
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Growing evidence indicates that large proportions of children around the world experience physical, sexual and emotional violence every year, with enormous implications for human rights, public health and economic and social development.1 Over the l
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ast five years, national governments and Together for Girls – a global public-private partnership comprising UNICEF,
other United Nations (UN) agencies, the United States (US) Government and various private sector agencies – have worked to mobilize and sustain a global movement to end violence against children, with a focus on sexual violence against girls.
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This year’s MPI results show that more than two-thirds of the multidimensionally poor—886 millionpeople—live in middle-income countries. A further 440 million live in low-income countries. In both groups, data show, simple
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national averagescan hide enormous inequality inpatterns of povertywithin countries. For instance, in Uganda 55 percentof the population experience multidimensional poverty—similartotheaverage in Sub-Saharan Africa. But Kampala, the capital city, has an MPI rate of sixpercent, whileinthe Karamojaregion, the MPI soars to 96 percent—meaningthat partsof Ugandaspan the extremes of Sub-Saharan Africa.There is even inequality under the same roof. In South Asia, for example, almost a quarter ofchildren under five live in households where at least one child in the household is malnourished but at least one child is not.
There is also inequality among the poor. Findings of the2019 global MPI paint a detailed picture of the many differences in how-and how deeply -people experience poverty. Deprivationsamong the poor varyenormously: in general, higher MPI valuesgo hand in hand with greater variationin the intensity of poverty. Results also show that children suffer poverty more intensely than adults and are more likely to be deprived in all 10 of the MPI indicators, lackingessentialssuch as clean water, sanitation, adequate nutrition or primary education
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Evidence for improving community health supply chains from Ethiopia, Malawi and Rwanda. Journal of Global Health vol. 4 No.2 (2014)
2nd edition - Published in 2003, the first WHO/HAI medicine prices manual Medicine Prices – A
New Approach to Measurement Draft for field-testing provides a draft methodology and tools to conduct national medicine prices and availability surveys
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. This second edition of the survey manual has been updated to reflect the wealth of practical
experience in conducting medicine prices and availability surveys garnered in the project’s first two phases.
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It is often observed that educated women have lower birth rates than do the less educated, inviting a causal interpretation. However, educated women also differ from those who have never attended school in a
variety of other ways: the two factors a
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re multiply related. This article analyzes the relationship between schooling and fertility in contemporary Cameroon as both a statistical and a social phenomenon, using data from the 1998 Cameroon DHS alongside ethnographic field data collected by
the author. T
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DHS Working Papers No. 127
The report shows that older people are not getting the healthcare treatments they desperately need. The COVID-19 response has disrupted services for non-communicable diseases such as cancer and diabetes, communicable diseases such as malaria, and much-needed services for mental health. Combined with
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a loss of income, many older people are unable to get the medicines they need.
A Summary is available in Russian and Arabic
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An international field study by African and German theologicans and health workers.
Inferences through Machine Learning.Background Report.
What are the major origins and drivers of different types of conflict? Sorting out the main
causes
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of conflict and war is difficult and often shaped by ideological believes. Even today,
historians and political scientists have discussions on the primary causes of the First World
War. There are several types of conflict, ranging from international and civil wars to local
conflicts, riots and revolution. And there are many theories that explain these different types
of conflict, which mostly focus on economic conditions and a range of factors that can foster
grievances and greed, creating incentives to initiate or join a conflict
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