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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Technical Report
AIDS Medicines and diagnostics service
July 2015
World Journal of Pharmaceutical and Medical Research vol. 5 (2019) 3, 129-132
Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance
Guidance has been updated on a number of chemicals: asbestos, bentazone, chromium, iodine, manganese, microcystins, nickel, silver, tetrachloroethene and trichloroethene. Guidance has also been added for chemicals not previously assessed in the Guidelines: anatoxin-a and analogues, cylindrospermopsi...ns and saxitoxins. The new guidance on organotins has replaced the prior guidance focused on dialkyltins. With these updates, the guideline values for tetrachloroethene and trichloroethene have been revised while new guideline values for cylindrospermopsins, manganese, microcystins, and saxitoxins have been established .
Updated information on cyanobacteria has been included, introducing an alert level framework for early-warning and to guide short-term management responses. Guidance has also been updated in the sections on adequacy of water supply, climate change, emergencies, food production and processing, and radiological aspects, particularly on managing radionuclides when exceeding WHO screening values and guidance levels.
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The COVID-19 pandemic is having far reaching impacts, well beyond the health crisis and needs, with the most severe impacts experienced in the poorest countries and those most vulnerable to humanitarian crises including natural disasters, such as Nepal.
Physical distancing measures are important to reduce COVID-19 transmission. However, when stringently applied, they can result in negative health and socio-economic impacts. This report draws on a rapid review of available literature, case studies from across Africa and expert knowledge to make reco...mmendations on adapting classic physical distancing measures to the contextual realities in Africa and on mitigating potential negative impacts.
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Technical Report
AIDS Medicines and diagnostics service
September 2016
This research report provided results from the study of living conditions among people with functional limitation in Mozambique. Two comparative studies of different indicators of living conditions were carried out. These studies include: (i) a comparative study of households with and without family... member(s) with functional limitation and (ii) a comparative study of individuals with and without functional limitation. In addition, a detailed study that specifically addresses the situation of individuals with functional limitation was also conducted. The Mozambique study was undertaken in 2007 – 2008.
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Research Paper.
As the fighting in Syria winds down, international humanitarian organisations (IHOs) operating from Damascus are hopeful that the Syrian government’s interference in their work will decrease. However, the government is attempting to formalise its influence over humanitarian operat...ions.
Throughout the Syrian conflict, the government has imposed multiple administrative processes on humanitarian organisations to limit their ability to operate independently. This includes restricting the operational environment; undermining organisational independence; imposing local partners; influencing procurement procedures; and preventing direct monitoring and evaluation.
While some level of coordination with the government might be a pragmatic necessity to ensure the safety of operations in regime-controlled areas, this cooperation should not enable the government to use aid for military or political purposes. Consequently, international humanitarian organisations have an ethical dilemma in how they provide aid in these areas without undermining their principles of humanity, independence, impartiality and neutrality.
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2nd edition. The interagency field handbook on malaria control was developed to set out effective malaria control responses in humanitarian emergencies, particularly during the acute phase when reliance on international humanitarian assistance is greatest. This second edition represents a thorough u...pdating and revision of the first edition. The structure remains similar, but includes an additional chapter on humanitarian coordination. All chapters have been revised to reflect changes in best practices, improvements in technologies, availability of new tools, and changes in WHO recommendations.
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