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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Men lag behind women regarding use of HIV services and represent the majority of individuals living with uncontrolled HIV, advanced HIV, and who experience HIV-related mortality. Men (15+) globally are less likely than women (15+) to know their HIV status (83% for men vs 91% for women), be on antire...troviral treatment (ART) (72% for men vs 83% for women) and reach viral suppression (67% for men vs 78% for women).
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The limitation of a single sector approach. HNP Discussion Paper
Examination of the business behavior of Boehringer Ingelheim, Bayer and Baxter in India
South Eastern European Journal of Public Health, EEJPH 2016, posted: 11 January 2016. DOI 10.4119/UNIBI/SEEJPH-2016-85
A Cost-Efficiency Analysis for the Kyrgyz Republi
Cognitive deficits in schizophrenia can massively impact functionality and quality of life, furthering the importance of cognitive training. Despite the development of the field in Europe and in the United States, no programmes have been developed and tested in developing countries. Different cultur...al backgrounds, budget restrictions, and other difficulties may render treatment packages created in high income countries difficult for adoption by developing nations. We performed a pilot double-blind, randomized, controlled trial in order to investigate the efficacy and feasibility of an attention and memory training programme specially created in
a developing nation. The intervention used simple, widely available materials, required minimal infrastructure, and was conducted in groups.The sample included seventeen stable Brazilians with schizophrenia. Sessions were conducted weekly during five months. The cognitive training group showed significant improvements in inhibitory control and set-shifting over time. Both groups showed improvements in symptoms, processing speed, selective attention, executive function, and long-term visual memory. Improvements were found in the control group in long-term verbal memory and concentration. Our findings reinforce the idea that cognitive training in schizophrenia can be constructed using simple resources and infrastructure, facilitating its adoption by developing countries, and it may improve cognition.
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The joys and the hopes, the griefs and the anxieties of the men of this age are the joys and hopes, the griefs and anxieties of the followers of Christ. As a community composed of men, united in Christ, they are led by the Holy Spirit toward the Kingdom of their Father. They have welcome...d the news of salvation, meant for every man. This community realizes its link with mankindand its history by the deepest of bonds
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This guide is designed to accompany the training module, Communicating with health workers about COVID-19 vaccination. It provides detailed explanations, resources and guidance to accompany the slides in the training module and support those implementing the training. It is intended for training fac...ilitators or trainers of trainers (ToTs) who will be conducting the training at the country level either face-to-face or online with a group of participants. Facilitators can use this guidance document to help them adapt the training content to their local context and facilitate discussion with training participants. Facilitators are encouraged to have this guide available to them as a tool during the training session.
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The following technical report outlines the rationale, process and results of a joint research study, coordinated by the World Health Organization (WHO) and the Pan-American Health Organization (PAHO), co-chaired by the Ministry of Health and Social Protection and the Ministry of Environment and Sus...tainable Development in collaboration with the Climate and Climate Air Coalition, the Stockholm Environment Institute, the Clean Air Institute and leading international and national experts. A rationale section describes the links between greenhouse gas (GHG) emissions, short-lived climate pollutants, air pollution and adverse health outcomes. A summary of the research study describes how scenarios were modelled to examine the health and economic implications of raising ambition in Colombia’s Nationally Determined Contribution (NDC) to the United Nations Framework Convention on Climate Change (UNFCCC)
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SUI supporting material
• Person stories
• Role plays
• Multiple choice questions
• Video link
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
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