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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.more
This document sets out, therefore, to explain the socioeconomic value of investing in the fight against NTDs and highlights priorities for global investment attention. Our work was guided by the need not only for
additional funding and funders but also for the need to understand the current funding... climate, in which value for money and the efficient use of resources to fill the most critical of gaps are more relevant than ever.more
The technical note by the Global Task Force on Cholera Control (GTFCC) discusses the use of Oral Cholera Vaccines (OCVs) for international workers and travelers in cholera-affected areas. It reviews the effectiveness of WHO-prequalified vaccines (Dukoral®, Shanchol™, and Euvichol®), emphasizing ...their role in preventing infection and reducing transmission risks.
The document highlights concerns about travelers contracting cholera in endemic regions and potentially spreading the disease upon returning home. While the overall risk is considered low, certain groups, such as humanitarian workers and travelers to high-risk areas like South Asia, face a higher exposure.
Recommendations include vaccination for emergency and relief workers who may come into direct contact with cholera patients or contaminated environments. However, routine vaccination for general travelers is not widely recommended. The note also calls for better surveillance and studies to assess the potential of vaccines in preventing international transmission.more
N95 or equivalent respirators are single-use personal protective equipment (PPE) designed for use by health workers that provide direct care to patients with diseases transmitted by aerosols or during aerosol generating procedures (AGP) for patients with acute respiratory disease, as is the case of ...COVID-19. • Given the current shortage of N95 and equivalent respirators, the World Health Organization (WHO) has suggested the possibility of their extended use by the same individual for up to 6 hours or the reprocessing of respirators when necessary.more
This clinical management manual for Ebola Viral Disease in Liberia was developed after several ETUs were established in the country following the outbreak early this year. As the outbreak evolved, it became evident that different SOPs were being used by clinicians across these treatment facilities. ...As a result of discussions held by the National Case Management Committee of the Incident Management System, various stakeholders were brought together to contribute their time and expertise to the development of this manual.more
This Cardiac Rehabilitation Change Package was completed by the Centers for Disease Control and Prevention (CDC) in collaboration with the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) with the purpose of helping cardiac rehabilitation programs, hospital quality improv...ement teams, and public health professionals who partner with these groups to implement systems and strategies that improve care for patients who are eligible for cardiac rehabilitation. AACVPR is a multidisciplinary professional association comprised of health professionals who serve in the field of cardiac and pulmonary rehabilitation.more
Este livro de bolso destina-se a ser usado por médicos, enfermeiras e outros trabalhadores de saúde experientes que sejam responsáveis pela prestação de cuidados de saúde a crianças nos países em desenvolvimento.