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
The limitation of a single sector approach. HNP Discussion Paper
South Eastern European Journal of Public Health, EEJPH 2016, posted: 11 January 2016. DOI 10.4119/UNIBI/SEEJPH-2016-85
Five years after a global commitment to Fast-Track the HIV response and end AIDS by 2030, the world is off track. A promise to build on the momentum created in the first decade of the twenty-first century by front-loading investment and accelerating HIV service provision has been fulfilled by too fe...w countries
more
Curr Psychiatry Rep. 2011 Dec;13(6):493-9. doi: 10.1007/s11920-011-0229-8.
The International Journal of Tuberculosis and Lung Disease 21(5) DOI: 10.5588/ijtld.16.0518
This note sets out actions to be undertaken throughout the humanitarian programme cycle (HPC) to fulfill commitments on Accountability to Affected Populations (AAP) and to ensure that protection is central to humanitarian response. It sets out the fundamental link between accountability systems and ...protection in humanitarian action, and then describes, for each stage of the HPC, the accountability mechanisms that should be established and actions required at country-level.
more
Working towards better COVID-19 outcomes in the WHO European Region.From the first COVID-19 cases in Europe reported on
24 January 2020, the pandemic reached 1 million cases
within 3 months, 10 million cases within 8 months, and
100 million cases in Europe alone within 2 years. Over
the course o...f its two years, COVID-19 has claimed over
1.6 million lives across Europe and Central Asia. The
World Health Organization (WHO) European Region has
accounted for close to a third of the cumulative global
COVID-19 cases and deaths.
more
Mental illness can affect not only the life of the person with the illness, but also their close family, partners
and friends. Significant people in a person’s life are often a source of support with the illness.
However, family, partners and friends may be faced with a loved one’s men...tal illness without much
information on ways to deal with it and its impact on their life.
NOTE: This guide is NOT a replacement for medical advice and we strongly recommend that you or the person you care
for discuss issues related to treatment with a clinician.
more