An Overview of Current Evidence with Recommendations for Strengthening Community Health Worker Programs to Accelerate Progress in Achieving the Health-related Millennium Development Goals
This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major cha...llenge in large-scale CHW programmes is the need for CHWs to establish and maintain benefcial relationships with both sets of actors, who may have diferent expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities.
more
To Initiating a Maternal, Neonatal and Child Health Project in Urban Slums with Social Mapping, Census Taking, and Community Engagement
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 such programs face and what can be done to make them a...s 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
more
Bull World Health Organ 2020;98:773–780
Universal health coverage (UHC) depends on a strong primary health-care
system. To be successful, primary health care must be expanded at community and household levels as much of the world’s population still lacks access to health facilities for basic... services. Abundant evidence shows that community-based interventions are effective for improving health-care utilization and outcomes when integrated with facility-based services. Community involvement is the cornerstone of local, equitable and integrated primary health care.
more
This is the sixth of our 11-paper supplement entitled “Community Health Workers at the Dawn of New Era”. Expectations of community health workers (CHWs) have expanded in recent years to encompass a wider array
of services to numerous subpopulations, engage communities to collaborate with and to... assist health systems in responding to complex and sometimes intensive threats. In this paper, we explore a set of key considerations for training of CHWs in response to their enhanced and changing roles and provide actionable recommendations based on
current evidence and case examples for health systems leaders and other stakeholders to utilize.
more
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 such 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. Throughout, we discuss major policy and programmatic issues that decision-makers and planners need to consider when designing, implementing, scaling up or strengthening a national-level CHW program. We offer an overview
of specific challenges CHW programs face, country lessons, tools, and other resources that may be helpful, while incorporating relevant programmatic examples as much as possible.
more
Детям нужна безопасная и надежная окружающая среда, которую они могут назвать своим домом. Кроме выполнения функции жилища, дом должен служить местом физической и ...эмоциональной безопасности, где дети могут обрести комфорт и защиту. Следовательно, оптимальное развитие зависит от взаимодействия между позитивным влиянием окружающей среды и унаследованной генетической предрасположенностью, которое начинается уже в период внутриутробного развития (Shonkoff et al, 2000). Исследования показали, что негативный опыт раннего детства может иметь отдаленные последствия для детей, включая изменения структуры головного мозга (National Scientific Council on the Developing Child, 2004).
more
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 expan...ding 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.
more
Advance chapters from the new edition
This guide is intended to support national governments developing their national deployment and vaccination plans (NDVPs) for COVID-19 vaccines by outlining the roles, needs and opportunities for community health workers (CHWs) to contribute. This note builds on and is structured to align with the G...uidance on developing a national deployment and vaccination plan for COVID-19 vaccines. By providing CHW-relevant considerations for the VIRAT Tool, this document aims to support national governments in developing robust NDVPs for introducing COVID-19 vaccine(s) that leverage all the community-based deployment, implementation and monitoring tools at their disposal.
more
The role of community health workers in the vaccination against COVID-19: guide to support the implementation of the vaccination programme
The article focuses on "The State of the World’s Children 2023" report published by UNICEF. It highlights the critical role of vaccines in saving lives and the challenges in global immunization efforts, especially for marginalized and underserved children. The report emphasizes the impact of COVID...-19 on routine immunization, leaving millions of children unprotected from preventable diseases. It calls for urgent measures to restore and improve vaccination coverage, ensure equity in vaccine access, strengthen primary healthcare systems, and build trust in vaccines. The report also advocates for innovations and sustainable funding to achieve immunization for every child.
more
The article focuses on "The State of the World’s Children 2023" report published by UNICEF. It highlights the critical role of vaccines in saving lives and the challenges in global immunization efforts, especially for marginalized and underserved children. The report emphasizes the impact of COVID...-19 on routine immunization, leaving millions of children unprotected from preventable diseases. It calls for urgent measures to restore and improve vaccination coverage, ensure equity in vaccine access, strengthen primary healthcare systems, and build trust in vaccines. The report also advocates for innovations and sustainable funding to achieve immunization for every child.
more
Recommendations to develop guidelines on community-based rehabilitation (CBR) were made during the International Consultation to Review Community-based Rehabilitation which was held in Helsinki, Finland in 2003. WHO; the International Labour Organization; the United Nations Educational, Scientific ...and Cultural Organization; and the International Disability and Development Consortium – notably CBM, Handicap International, the Italian Association Amici di Raoul Follereau, Light for the World, the Norwegian Association of Disabled and Sightsavers – have worked closely together to develop the Community-based rehabilitation guidelines. More than 180 individuals and representatives of nearly 300 organizations, mostly from low-income and middle-income countries around the world, have been involved in their development.
more
Rabies is a fatal viral zoonosis and serious public health problem.1 All mammals are believed to be susceptible to the disease, and for the purposes of this document, use of the term animal refers to mammals. The disease is an acute, progressive encephalitis caused by viruses in the genus Lyssavirus....
2 Rabies virus is the most important lyssavirus globally. In the
United States, multiple rabies virus variants are maintained in wild mammalian reservoir populations such as raccoons, skunks, foxes, and bats. Although the United States has been declared free from transmission of canine rabies virus variants, there is always a risk of reintroduction of these variants.The rabies virus is usually transmitted from animal to animal through bites. The incubation period is
highly variable. In domestic animals, it is generally 3 to 12 weeks, but can range from several days to months, exceeding 6 months.8 Rabies is communicable during the period of salivary shedding of rabies virus. Experimental and historic evidence documents that dogs, cats, and ferrets shed the virus for a few days prior to the onset of clinical signs and during illness. Clinical signs of rabies are variable and include inappetance, dysphagia, cranial nerve deficits, abnormal behavior, ataxia, paralysis, altered vocalization, and seizures. Progression to death is rapid. There are currently no known effective rabies antiviral drugs.
more