Facilitator's Guide. This guide is designed to assist facilitators in training community health workers (CHWs) and community volunteers (CVs) in integrating community-based TB services into their work. The training will help community workers who already provide numerous services to understand TB an...d contribute to prevention, care and support services in their communities
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Raport național, 2014
Chișinău – 2015
Guía detallada para el diseño e implementación de métodos de encuestas de conocimientos, actitudes y
prácticas para programas de protección de la infancia
BMC Health Services Research (2017) 17:623 DOI 10.1186/s12913-017-2567-7
Quality Standards for community health services Level 1
Acclerating attainment of universal health coverage and bridging the access inequity gap
This document was conducted as a desk study and provides useful information and practical examples of responses to HIV and AIDS in the fields of agriculture, rural development, self-help and social protection. It aims to invite Misereor partners and others working in these fields to reflect on their... current approaches and to encourage them to respond, in their core business, to the challenges presented by HIV and AIDS.
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(Health Systems in Transition, Vol. 4, No. 3, 2014)
2ª edição atualizada.
O Manual de Recomendações apresenta as diretrizes nacionais para o controle da doença, que incluem procedimentos clínicos padronizados, procedimentos laboratoriais, sistema de vigilância, ações de biossegurança e organização de serviços. Apesar de conter as reco...mendações clínicas no que diz respeito à padronização de ações de busca de casos e tratamento, o manual está destinado às ações voltadas para a saúde pública e não pretende ser um guia clínico sobre a doença. Dessa forma, não substitui livros, textos e publicações acadêmicas que identifiquem boas práticas clínicas sobre a abordagem do sintomático respiratório e do paciente com tuberculose nos seus variados aspectos e especificidades.
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En esta obra se presentan mensajes básicos para pasar a la acción, resumidos
en una serie de capítulos sobre diversos temas ligados a la salud ambiental,
consultables en línea en: http://www.who.int/ceh/publications/hehc_booklet/en/
index.html
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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Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
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