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
Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of ...diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
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More and more countries are completing their epidemiological mapping of trachoma in suspected
endemic districts and are preparing to distribute Zithromax® in those districts where the prevalence of
“trachomatous inflammation – follicular” (TF) is above 5% among children aged 1-9 years. Mass... drug
administration (MDA) is normally at the district level and targets the whole population with Zithromax®
tablets to those 5 years old and above; Zithromax® suspension for children between 6 months and 5
years of age; and tetracycline eye ointment 1% for infants up to 6 months old.
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A practitioner’s guide to the principles of COVID-19 vaccine communications.
The factors that lead people to make choices to take vaccines are nuanced and affected by how they see the world, their perceptions of the choices people like them will make, who they trust, their perceptions of risk,... consistency of message and convenience of actually getting the vaccine.
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The importance of fruits and vegetables in nutritious and healthy diets is well recognized, and in recent years consumers have been encouraged to eat more of these products. For many countries, particularly developing countries, these products have become a valuable commodity. At the same time, food... safety problems linked to the consumption of fresh fruits and vegetables contaminated with microorganisms are increasing
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Not long ago, on the occasion of the 100th anniversary of the discovery of Chagas disease, several campaigns denounced the scant progress has been made in diffrent spheres- medical, scientific and politcal- but major challanges still remain. This is an appropriate time to celebrate what has been ach...ieved and to take the next step.
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2nd edition. This Permagarden Technical Manual is a resource for agriculture project staff implementing home garden projects with farmers. The manual explains how the permagarden method addresses soil health, water management and crop protection to create a year-round productive home garden. It incl...udes an explanation of the purpose and reasoning behind the method, as well as instructions on how to implement the different practices
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Conflict, climate change, the COVID-19 pandemic, and the economic effects of the Ukraine crisis are interacting to create new and worsen existing hunger hotspots, reversing the gains families had made to escape poverty.
Schools are generally the most popular setting for drug-use-
prevention programmes, and are used both by governmental and
non-governmental agencies. This may be for many reasons: ease of
obtaining funding for school drug-use-prevention programmes, the
captive audience, and the popular perception... that drug prevention
should start from schools, or the need to show that action is being
taken to control a serious social problem.
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After ten years of war, the vast majority of Syria’s children cannot imagine a future in their country, according to a new report by Save the Children. On average, 86% of Syrian refugee children surveyed in Jordan, Lebanon, Turkey and the Netherlands said they would not want to return to their cou...ntry of origin. Of children displaced inside Syria, one in three would rather be living in another country. Children who fled their homes are struggling to feel safe where they are now, as around two in five children of those surveyed by Save the Children said they face discrimination and a lack of education. Many feel they have no say over their future.
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