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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Case Studies on Building Resilience in the Horn of Africa
The environment in which young people live, learn and play significantly affects their decisions about whether to consume alcohol. Environmental factors are the main risk factors driving alcohol consumption and related harm among young people. Environments that normalize alcohol consumption – term...ed alcogenic environments – include contexts with unregulated advertising and marketing of alcoholic beverages, higher alcohol outlet density, products designed to facilitate affordability and low prices of alcoholic beverages. A recent body of research evidence has emerged related to the measurement, functional significance and consequences of living in alcogenic environments. This includes findings on the complex and bidirectional interactions among alcohol acceptability, availability and affordability and how they create and perpetuate alcogenic environments. Comprehensive and enforced alcohol control policies are effective at delaying the age of onset and lowering alcohol prevalence and frequency among young people. Evidence consistently confirms the effectiveness of designing and implementing alcohol control policies that regulate upstream the drivers of alcogenic environment, including alcohol availability, acceptability and affordability. These policies need to be multipronged and address the complex interactions between these drivers and the local alcohol culture
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A Program To Improve The Care For Patients With Common Mental Disorders In Primary Health Care.
The essence of the MANAS model is to shift mental health care from mental health specialists to primarycare doctors and lay HCs (someone similar to other more widely available... health workers) working as aprimary care team to improve the coverage and efficiency in treating CMD. This manual has been prepared based on the experience gained through the MANAS program and incorporates feedback from doctors who were involved in the program implementation. It outlines the details of the MANAS model and provides information on treatments that are relevant to doctors working in Primary Health Clinics
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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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SUI supporting material
• Person stories
• Role plays
• Multiple choice questions
• Video link
Reporting period January 2015 – December 2015
Bucharest, April 2016
Technical Report
AIDS Medicines and diagnostics service
July 2015
This concept note describes the methods used to assess the prevalence of any HIVDR and HIVDR by PMTCT exposure among children less than 18 months of age using remnant dried blood spot specimens from early infant diagnosis over a 12-month period
front cover © Hannah Maule-Ffinch/Save the Children
Disability at a Glance 2015 focuses on barriers to the employment of persons with disabilities in the Asia-Pacific region, and offers solutions to strengthen their employment prospects. Employment is not only the primary means of livelihood generation; it also provides individuals with the purpose a...nd meaning of playing a productive role in society. Equal access to employment is therefore vital, and barriers to work faced by persons with disabilities must be removed.
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Participatory Learning and Action Planning; A Facilitator's Guide