Prices people pay for medicines.
HIV/AIDS - Research and Palliative Care 2016:8 183–193
Cadre pour la planification, l'ebaoration et la mise en oeuvre de solutions avec et pour les jeunes e
UNAIDS and DPKO non paper | 2011
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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One key aim of tuberculosis (TB) prevention and care is to render them more people-centred, which means further boosting and improving ambulatory care models across the countries of Eastern Europe and central Asia. This note is intended to remind interested parties of the evidence that shows that am...bulatory care is both feasible and safe
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Updated on 6 APRIL 2020
There are serious concerns that the situation might escalate in the next weeks modelling the epi curve of other regions. The interlinkages between human mobility and the current pandemic of COVID-19 are well established, and while international flights have been suspended i...n the region, the porous borders on land and water crossings remain difficult to control.
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