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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 relative to the absence ... 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.
The new Global Strategy aims to achieve the highest attainable standard of health for all women, children and adolescents, transform the future and ensure that every newborn, mother and child not only survives, but thrives.
NSP Review
Engaging with South Africa’s National Strategic Plan for HIV, STIs and TB Edition 7 July – August 2013
A publication of the Treatment Action Campaign and SECTION27
GeneXpert: An imperfect rollout
TB in South African prisons: Whe...
Humanitarian emergencies, regardless of type and cause, have a number of common risk factors for communicable diseases inextricably linked to excess risk ... morbidity and mortality which can come from vaccine–preventable diseases (VPDs). The reduction of VPDs is a significant aim of public-health interventions during crises.
The WHO Strategic Advisory Group of Experts (SAGE) on Immunization carried out a comprehensive review of evidence on vaccination decision-making processes and considerations in humanitarian emergencies.
This article unites the latest guidelines on the management of arterial hypertension in primary health care in Portuguese speaking countries including Brazil, Angola, Mozambique, São Tomé e Príncipe, Cape Verde, among others.
This publication’s primary purpose is to provide a compilation of actions to address malnutrition in all its forms, in a concise and user-friendly format to help in decision-making processes for integration ... nutrition interventions in national health policies, strategies, and plans based on country-specific needs and global priorities.
Measuring progress towards universal health coverage.
This sixth edition of Health at a Glance Asia/Pacific presents a set of key indicators of he...
Human activities are driving fundamental changes to the biosphere and disrupting many of our planet’s natural systems. There is increasing scientific evidence that the unfolding climate crisis, global pollution, unprecedented levels ... biodiversity loss, and pervasive changes in land use and cover threaten nearly every dimension of human health and wellbeing
Despite its rich culture, great economic potential, high level of education and last but not least its sheer size – it is the largest state whose borders lie entirely within Europe and is 1.7 times the size ... the Federal Republic of Germany – Ukraine seems far away in perception and awareness. Publications on recent dramatic events, such as the Ukraine conflict or the Crimea crisis, have done little to change this. In fact, the armed conflict in the eastern Ukrainian oblasts of Donetsk and Luhansk, which has been ongoing since February 2014, is still a burdening feature of many political and economic difficulties destabilizing the country. News coverage of health issues in Ukraine has recently been dominated by highly critical reports on the handling of the Covid 19 pandemic. This pandemic exacerbated existing weaknesses in the Ukrainian health care system, but at least it did not create any new ones.
This global progress report attempts to lay the groundwork for the kind of accelerated action needed. Section 1 presents key data, trends and developments in women’s, children’s and adolescents’ health and well-being. That is followed in Secti...
A lot has happened this year. While we continued to tackle the COVID-19 pandemic, we were hit by disease outbreaks and
humanitarian crises. Yet, despite these challenges, we marched on, resolute in resolving critical health systems issues to increase
access to quality healthcare services. To furth...
Obesity in all age groups, including children and adolescents, is a public health challenge across all settings. Obesity is now classified as a complex multifactorial chronic disease and not just a risk factor for other noncommunicable diseases and comorbidities. Recognizing the significance ... primary health care for an effective and efficient response to the obesity epidemic, the World Health Organization (WHO) has developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach.
While there has been real progress in addressing the burden of disease in the WHO African region, the COVID-19 pandemic has highlighted the link between health, economics and security, as the region saw decades ... progress threatened, including positive trends in decreasing inequality. In the African Region the momentum towards achieving the 2030 SDG disease burden reduction targets (SDG targets 3.3, 3.4 and 3B) has stalled.
The COVID-19 pandemic was also a major threat to gains made, such as the eradication of polio in the region, declared in 2020; reduced numbers of new HIV infections in 2021 compared to 2010; and passing the 2020 milestone of the End TB Strategy, with a 22% reduction in new cases compared with 2015. However, the pandemic also disrupted essential health services in 92% of countries globally, 22.7 million children missed basic immunization, there was an increase in malaria and TB, and global deaths from TB rose for the first time since 2015.
This country cooperation strategy (CCS) outlines how the World Health Organization (WHO) will work with the Lao People’s Democratic Republic over the next five years (2024–2028), supporting the implementation of the five-year health sector devel...
This manual provides a framework for morbidity management and disability prevention of patients affected by NIDs and gives specific guidance for the proper care of patients suffering from chronic co...
This manual provides a framework for morbidity management and disability prevention of patients affected by NIDs and gives specific guidance for the proper care of patients suffering from chronic co...
The WHO South-East Asia (SEA) Region bears a high burden of tuberculosis (TB) and MDR-TB. In 2015, the Region accounted for nearly 200 000 or 35% of the global estimated new RR/MDR-TB c...
There is no secret to our procedure: the daily scanning of the literature helps us to stay afloat in the never-ending waves of new publications about SARS-CoV-2 and COVID-19. Many papers discussed i...
Promoting health and preventing disease is a critical component of the effort required to achieve Universal Health Coverage (UHC). to date, efforts to achieve UHC have focused mostly on strengthening health systems and their capacities to provide cu...
This analytical report reviews and discusses the potential role and influence of political commitment in implementing endorsements and conducting policy in the field of tuberculosis (TB) prevention ...
