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... 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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This brief document aims to provide a framework for WHO assistance in this area.
Further analysis of the 2011 Nepal Demographic and Health Survey
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 ...hlight medbox">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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The report “Dementia: a public health priority” has been jointly developed by WHO and Alzheimer's Disease International. The purpose of this report is to raise awareness of dementia as a public health... priority, to articulate a public health approach and to advocate for action at international and national levels.
Dementia is a syndrome that affects memory, thinking, behaviour and ability to perform everyday activities. The number of people living with dementia worldwide is currently estimated at 35.6 million. This number will double by 2030 and more than triple by 2050. Dementia is overwhelming not only for the people who have it, but also for their caregivers and families. There is lack of awareness and understanding of dementia in most countries, resulting in stigmatization, barriers to diagnosis and care, and impacting caregivers, families and societies physically, psychologically and economically.
Available Languages: Chinese, English, Japanese, Russian and Spanish
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The report focuses on several key areas where health outcomes are falling short, and provides insight into ways in which countries can improve the situation for their children and adolescents. Areas in focus include mental ...highlight medbox">health, overweight/obesity and adolescent risk-taking behaviour.
The report shows, for example, that:
- mental health remains a neglected subject – only one quarter of countries are collecting data on the number of children treated by a mental health professional;
- half of countries do not regulate the marketing of food to children, despite the fact that childhood obesity rates are high across the Region and physical activity rates are low;
- almost half of countries have no policy that affects the availability of unhealthy foods at school;
- 2 in 5 girls and 1 in 3 boys who are having sex do not protect themselves; and
one third of countries do not offer legal access to contraception without parental consent for those under 18 years of age.
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Assessment of the quality of institutional care for adults with psychosocial and intellectual disabilities in the WHO European Region.
The specific objectives of the project were to address gaps in knowledge about the number and characteristics of such long-term institutions and to identify deficie...ncies in current care standards through the lens of the United Nations Convention on the Rights of Persons with Disabilities. This publication examines and rates the quality of care and protection of human rights in selected institutions in over 20 countries in the Region using the WHO QualityRights toolkit. It identifies steps to take to continue progress toward deinstitutionalization and to ensure respect for the rights of people with psychosocial and intellectual disabilities.
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This document aims to assist policy‑makers, health care providers and researchers to understand key concepts in health ethics and to identify basic ethical questions surrounding ...bute-to-highlight medbox">health and health care. It illustrates the challenges of applying ethical principles to global public health and outlines practical strategies for dealing with those challenges.
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New and updated information.
Adverse health effects of hot weather and heat-waves are largely preventable. Prevention requires a portfolio of actions at different levels:from health system pr...eparedness, coordinated with meteorological early warning systems, to timely public and medical advice andimprovements to housing and urban planning. This publication offers detailed information for various target audiences, and on medicaladvice and treatment practices
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A multidisciplinary and multisectoral collaboration, through a One Health approach is required to effectively prepare for, detect, assess, and respond to emerging and endemic zoonotic diseases. However, external and internal ...o-highlight medbox">health system evaluations continue to identify major gaps in capacity to implement multisectoral and multidisciplinary collaboration within and between many countries, and countries are asking for support from the Tripartite to fill these gaps. This guide is the response to those requests.
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Overwhelming evidence shows that a range of health concerns—mental illness, substance dependence, HIV/AIDS, and noncommunicable diseases—affect prisoners disproportionately. But, while incarceration poses risks to ...ight medbox">health—including inadequate nutrition and exposure to violence—prisons also present important opportunities to promote health and risk reduction that need to be tapped.
Some recommended remedies:
Health ministries, not ministries of justice, should manage health care responsibilities
Ensure that testing is available, but not mandatory, for infectious diseases
Make prison health part of the broader public health agenda
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