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Diabetes is a serious, chronic disease that occurs either when the pancreas does not produce enough insulin (a hormone that regulates blood sugar, or glucose), or when the body cannot effectively use the insulin it produces. Diabetes is an important public
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health problem, one of four priority noncommunicable diseases (NCDs) targeted for action by world leaders. Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades
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The document "Global Report on Diabetes" by the World Health Organization (WHO) provides an in-depth analysis of diabetes as a global health challenge. It covers the rising prevalence of the disease
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, the associated risk factors, and the increasing burden on healthcare systems, particularly in low- and middle-income countries. The report discusses strategies for preventing Type 2 diabetes, managing diabetes effectively, and reducing complications through integrated healthcare approaches. It emphasizes the need for global action, national policies, and collaboration across sectors to address diabetes and improve health outcomes worldwide.
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Lancet Glob Health 2015; 3: e396–409. Open Access
Progress Report
Malawi Demographic and Health Survey 2015-2016
recommended
DHS Further Analysis Reports No. 97
DHS Further Analysis Reports No. 108 - This report examines levels, trends, and inequalities in maternal health in Rwanda from 2010 to 2014-15 among women age 15-49 with a recent birth. The analysis uses Demographic and
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Health Survey (DHS) data for 15 key indicators of maternal health: 6 for antenatal care, 3 for delivery, 1 for postnatal care, and 5 for barriers to accessing medical care. Levels and trends in these indicators were analyzed overall and by three background characteristics: women’s education, household wealth quintile, and region.
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Levels and Inequities
DHS Further Analysis Reports No. 110
This study shows large variations in maternal health indicators across high-priority counties in Kenya. Nairobi exceeds the national average on all maternal ... health indicators in this study, while other highpriority counties consistently are disadvantaged compared with Kenya as a whole in most maternal health indicators. Kisumu exceeds the national average in use of antenatal care, delivery in a health facility, and postnatal care, but not other indicators. Nakuru has fewer women with fertility risk and fewer women who report that the distance they must travel to reach a health facility is a problem.
This study identifies a number of inequities in maternal health indicators across socio-demographic characteristics in the high-priority counties—most in the distribution of delivery care and least in antenatal care. Inequities are also observed in fertility risk and postnatal care. more
DHS Further Analysis Reports No. 110
This study shows large variations in maternal health indicators across high-priority counties in Kenya. Nairobi exceeds the national average on all maternal ... health indicators in this study, while other highpriority counties consistently are disadvantaged compared with Kenya as a whole in most maternal health indicators. Kisumu exceeds the national average in use of antenatal care, delivery in a health facility, and postnatal care, but not other indicators. Nakuru has fewer women with fertility risk and fewer women who report that the distance they must travel to reach a health facility is a problem.
This study identifies a number of inequities in maternal health indicators across socio-demographic characteristics in the high-priority counties—most in the distribution of delivery care and least in antenatal care. Inequities are also observed in fertility risk and postnatal care. more
Shaping Health programme on Learning from international experience on approaches to community power, participation and decision-making in health,AMHF, TARSC
Shortages of healthcare workers is detrimental to the health of communities, especially children. This paper describes the process of capacity building Community Health Volunteers (CHVs) to deliver
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integrated preventive and curative package of care of services to manage common childhood illness in hard-to-reach communities in Bondo Subcounty, Kenya
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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 of
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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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Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. Howe
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ver, consolidation of CHVs position within formal health systems has proved to be complex and continues to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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Emergencies, in spite of their tragic nature and adverse effects on mental health, are unparalleled opportunities to build better mental health systems for all people in need. This WHO publication s
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hows how this was done in 10 diverse emergency-affected areas
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A Reference Guide for Program Managers and Policy Makers. Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges suc
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h programs face and what can be done to make them as effective as possible. With this in mind, this manual is intended to be used a practical guide for policymakers and program managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale
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