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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Kangaroo mother care (KMC) is a critical strategy to care for preterm and low birth weight infants in resource-limited settings. Despite evidence of its effectiveness and low cost, coverage has remained low, largely due to sociocultural barriers. We aimed to better understand social norms and commun...ity perceptions of preterm infants and KMC (facility-initiated and community-continued) in Malawi, a country with a high preterm birth rate, to inform a pilot social and behavior change program.
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Single TB and HIV Concept Note Albania 2016-2018 27 April 2015
The strengthened plan aims to achieve and sustain a polio-free world through a focus on implementation and accountability. Emphasis will be on cutting outbreak response times; increasing vaccine demand; transforming campaign effectiveness; working systematically through integration; increasing acce...ss in inaccessible areas; transitioning towards government ownership; and improving decision-making and accountability.
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To meet our Strategy objectives and get within reach
of the 2030 SDG 3 target related to the three diseases,
the Global Fund needs to raise US$18 billion for the
Eighth Replenishment. That sum is essential to drive the
required pace of progress in the fight against HIV, TB
and malaria, and to m...aintain the necessary investments
in health and community systems.
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Etude nationale sur le financement du secteur de l’eau
Fact sheet
Good hygiene is critical to ensure that healthcare staff provide quality care, reduce the spread of infections, and protect the health of communities. This fact sheet explores the healthcare-related risks of poor hygiene and the critical elements of hand hygiene needed to improve qua...lity of care and reduce negative outcomes of poor compliance (e.g., healthcare-associated infections and antimicrobial resistance) in healthcare facilities, and provides recommendations and additional readings for improving hygiene in health settings and achieving a safe, clean healthcare environment.
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Alors que de nombreux pays touchés par le COVID-19 au cours des premiers mois de l'année commencent maintenant à assouplir les mesures de confinement à mesure que les taux d'infection et de mortalité diminuent, dans les régions les plus touchées par le VIH, la tuberculose et le paludisme, com...me l'Afrique, l'Asie du Sud et l'Amérique latine, la pandémie continue de s'accélérer. Dans les environnements à faibles ressources, les mesures de confinement sont moins efficaces et difficiles à maintenir, et les installations de soins cliniques sont extrêmement limitées. Dans de tels environnements, la réponse à COVID-19 doit se concentrer sur l'endiguement de la propagation de la pandémie par le dépistage, la recherche des contacts et l'isolement, la protection du personnel de santé par la formation et la fourniture d'équipements de protection individuelle (EPI) et la réduction de l'impact sur d'autres maladies par le renforcement des systèmes de santé fragiles et l'adaptation des programmes existants.
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This guidance note developed by UNICEF explains how the WASH sector can implement infection prevention and control measures in households and community settings. It focuses on reducing the exposure to the disease in vulnerable community settings and public spaces, and the transmission of the disease... in home and community settings hosting patients and contacts. This brief is available in English, Spanish, and French here.
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COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under di...fferent epidemiological scenarios.
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Les points qui suivent ont pour objectif de donner quelques éléments pour faciliter la continuité des activités de la réponse humanitaire en WASH au Burkina Faso.
The technical note from the Global Task Force on Cholera Control (GTFCC) examines the risks and benefits of vaccinating pregnant women with WHO-prequalified oral cholera vaccines (OCVs) during mass vaccination campaigns. It highlights that three WHO-approved vaccines (Dukoral®, Shanchol™, and Euv...ichol®) offer sustained protection and a strong safety profile.
While these vaccines are not explicitly contraindicated for pregnant women, there is limited clinical data on their use during pregnancy. However, studies indicate that pregnant women with cholera face higher risks of fetal loss, stillbirth, and complications, especially if they experience severe dehydration. Some evidence suggests that vaccination can reduce cholera incidence in pregnant women and indirectly protect infants.
Although no controlled trials have focused on pregnant women, retrospective studies in Guinea and Zanzibar showed no significant increase in adverse pregnancy outcomes after OCV administration. The GTFCC concludes that the benefits of vaccination outweigh the risks, particularly in high-risk areas, and recommends including pregnant women in cholera vaccination campaigns while continuing to monitor safety data.
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