Health Policy Plan (2017) 32 (5): 603-612; 10 pp. 318 kB
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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Strengthening competency based training of health care providers for Reproductive Maternal Newborn Child & Adolescenct Health (RMNCH + A) services
The Republic of the Union of Myanmar is at a historic moment, with a new civilian government assuming power in 2016. The country graduated to lower-middle-income status in 2015, and has made significant progress in reducing poverty, improving food security and addressing malnutrition.
The remai...ning challenges to food and nutrition security and achievement of Sustainable Development Goal 2 targets include continued population displacements resulting from conflict, vulnerability to extreme weather events, poverty, limited social protection coverage, high malnutrition and persistent gender inequalities.
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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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Q9: Antidepressant medicines in individuals with a depressive episode in bipolar disorder1Q9: In individuals presenting with a depressive episode in bipolar disorder, are antidepressant medicines effective and safe?
Treating children infected with intestinal worms is one of the simplest and most cost–effective ways to improve their health.
The recommendations are intended for a wide audience, including policy-makers and their expert advisers as well as technical and programme staff at government institution...s and organizations involved in the design, implementation and expansion of programmes to control soil-transmitted helminth infections.
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The document "Global Report on Diabetes" by the World Health Organization (WHO) provides an in-depth analysis of diabetes as a global health challenge. It covers the rising prevalence of the disease, the associated risk factors, and the increasing burden on healthcare systems, particularly in low- a...nd middle-income countries. The report discusses strategies for preventing Type 2 diabetes, managing diabetes effectively, and reducing complications through integrated healthcare approaches. It emphasizes the need for global action, national policies, and collaboration across sectors to address diabetes and improve health outcomes worldwide.
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Q10: In individuals with psychotic disorders (including schizophrenia) and bipolar disorders are psychoeducation, family interventions and cognitive-behavioural therapy feasible and effective?
Tsetse traps and targets (insecticide-impregnated screens) function by attracting the flies to a device that collects and/or kills them. Traps can be used for entomological surveillance, and also for control. Targets are simpler than traps, but are not used for surveillance. They are impregnated wit...h biodegradable insecticides in order to kill any flies that alight on them. Traps can also be impregnated with insecticides. Traps and targets can both be used to eliminate a fraction of the tsetse population.
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Module 1q
PrEP users
July 2017
Module 11: PrEP users. This module provides information for people who are interested in taking PrEP to reduce their risk of acquiring HIV and people who are already taking PrEP – to support them in their choice and use of PrEP. This module gives ideas for cou...ntries and organizations implementing PrEP to help them develop their own tools.
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Capability and Performance