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.
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Facilitator's Manual on life Skill Education, Stress Management and Suicide Prevention Workshops
This document is to guide policy makers, managers, districts, health workers, communities, NGOs and all other stakeholders on how to implement newborn health services.
Curr Psychiatry Rep. 2011 Dec;13(6):493-9. doi: 10.1007/s11920-011-0229-8.
Volumen 5 / Número 1 , 1025-1028 • http://www.revistabionatura.com
To describe the behavior of Tuberculosis/Human Immunodeficiency Virus co-infection in a cohort of people affected by sensitive Tuberculosis in Ecuador from 01 January 2010 to 31 December 2015. Results: The percentage of co...infected persons reached 11% in the whole period of study, with a range from 8.4% to 12.7%. Male sex shows the highest incidence rate, representing 76.7% at the rate of 1 man for every 3.3 women. The population with the highest incidence of patients is economically active; the age group of 25-34 years reaches 40.1%. The coastal zone of the country reports more than 75% of the coinfected patients. Conclusion: Increased HIV/AIDS screening should be increased for Tuberculosis, with particular emphasis on male sex and enhance the actions in the coastal provinces.
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Q12. SCOPING QUESTION: In people with psychotic disorders, including schizophrenia and bipolar disorder, are recovery-oriented strategies enhancing vocational and economic inclusion (such as supported employment) feasible and effective?
The Department of Health (DOH) has developed a National Integrated Sexual and Reproductive Health and Rights (SRHR) Policy.1 This policy addresses the many cross-cutting issues relating to SRH service provision, drawing together the principles, rights, and guidance for planning and implementation th...at underpin the provision of quality, comprehensive, and integrated SRHR services in South Africa. The National Integrated SRHR Policy is supported by several clinical and service delivery guidelines covering related programmatic
areas, including the National Contraception Clinical Guidelines.
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