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
Как близкий человека, страдающего наркоманией или находящегося под угрозой, вы находитесь в тяжёлом положении. Вы хотите понять его и помочь жить нормальной семей...ой жизнью или поддерживать партнерские отношения. Возможно, Вы боитесь, что знакомые отвернутся от Вас, узнав о зависимости. Не исключено, что с этим могут быть связаны финансовые проблемы. Не важно, кто Вы: мужчина или женщина, партнер, родитель, ребенок, бабушка/ дедушка или друг/подруга зависимого человека - эта информация для Вас! Поскольку Вы как близкий человек нуждаетесь в поддержке в этой трудной ситуации.
more
It offers tips and suggestions that contribute to mental well-being and maintaining a positive outlook on life. Theyare intended as food for thought – try to incorporate one or more of these suggestions into your daily routine and allow yourself to be surprised!
When anxiety holds you back from doing the things you want or need to do, it can
also affect your health. Some people become overwhelmed by fear and want to avoid situations that might make them frightened or anxious. It can be hard to
break this cycle, but there are lots of ways to do it. You can... learn to feel less fearful
and to cope with anxiety so that it doesn’t stop you from living.
more
The coronavirus disease 2019 (COVID-19) pandemic revealed systemic weaknesses in health-care systems
worldwide. The breadth of challenges left health workers overwhelmed and overstretched, reducing their professional efficacy and causing long-term issues with retention, recruitment and education of... future cohorts
more
Поради із підтримання психічного і фізичного здоров'я, безпеки, харчування, освіти та розвитку