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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Case Studies on Building Resilience in the Horn of Africa
This document is to guide policy makers, managers, districts, health workers, communities, NGOs and all other stakeholders on how to implement newborn health services.
Defending Rights
Breaking Barriers
Reaching People with HIV Services
Global Aids Update 2019
A consolidated set of reproductive health kits for use by humanitarian agencies. These kits are intended to speed up the provision of appropriate reproductive health services in emergency and refugee situations.
Working Document, September 2017
This report presents the key findings of the NFHS-5 in West Bengal, followed by detailed tables and an appendix on sampling errors. At the time of finalization of this report, wealth quintiles for the country as a whole were not ready. Therefore, on finalization of the national report, the breakup o...f key indicators by wealth quintiles for all states will be provided as an additional document and uploaded on the official website of MoHFW and IIPS.
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