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Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such
...
programs face and what can be done to make them as effective as possible. With this in mind, this manual is intended to be used a practical guide for policymakers and program
managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale. Throughout, we discuss major policy and programmatic issues that decision-makers and planners need to consider when designing, implementing, scaling up or strengthening a national-level CHW program. We offer an overview
of specific challenges CHW programs face, country lessons, tools, and other resources that may be helpful, while incorporating relevant programmatic examples as much as possible.
more
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 expanding 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
Gender-based violence, including rape is a problem throughout the world, occurring in every society, country and region. Refugees and internally displaced people are particularly at risk of this violation during every phase of an emergency situation
...
. The systematic use of sexual violence as a method of warfare is well documented and constitutes a grave breach of international humanitarian law.
The Arabic Version can be downloaded here: http://reliefweb.int/report/syrian-arab-republic/guidelines-health-staff-caring-gender-based-violence-survivors-including
more
Maternal Mental Health and child health and development in low and middle income countries
recommended
The impact of maternal mental health problems on infants in high income countries has been identified mostly in terms of psychosocial and emotional development, thanks to the groundbreaking early wo
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rk of Spitz (2) and of Bowlby (3), who studied the emotional needs of infants and mother-child attachment. Subsequently, a large body of literature, also from HICs, documented the effects of maternal mental health on the child's psychological development (4), intellectual competence(5), psychosocial functioning (6) and rate of psychiatric morbidity (7, 8).
more
Miscellaneous
Child and adolescent psychiatric emergencies
Chapter J.1
Cerebrum. 2016 Jul-Aug; 2016: cer-10-16.
Published online 2016 Jul 1.
Miscellaneous
Chapter J.5
An Easy-Reference Guidebook for Healthcare Providers In Developed and Developing Countries
Introduction
Chapter A.14
Externalizing disorders
Chapter D.1
Attention deficit hyperactivity disorder
Needs and barriers for mental health and psychosocial support among syrian refugees in lebanon: perspectives for future interventions
European Union Civil protection and Humanitarian Aid
European Union Civil protection and Humanitarian Aid
(2018)
CC
Results
Recommendations• NGOs should provide MHPSS services with a focus on empowerment and self-reliance
• Introduce interventions focusing on pain mechanisms, coping strategies and physical resilience
• Implement livelihood programmes
• Increase service accessibility and outreach activ
...
ities
• Provide support groups for people who have lost a close family member
• Highlight the importance of supervision and training
• Ensure high quality service provisions by applying relevant outcome measures and to further contribute to the evidence base for MHPSS
• Diversify MHPSS activities to different target groups, including men and women, and address the needs of elderly and individuals with disabilities
This study provides evidence of a large gap between the need of MHPSS among Syrian refugees and provided services. Of the 1082 respondents in this study, 62% expressed that they needed assistance to deal with physical pain and distress. Almost 80% reported being in pain, of which 27% were in severe or very severe pain. Additionally, 55% suffer from distress and 56% rate their own health as fair or poor. Even among the 18-25-yearolds, the prevalence of reporting their overall health as fair was 30.7%. For functionality levels, 28.5% felt severely or extremely emotionally affected by their health problems, and more than 20% had serious difficulties in doing day-to-day work. On the other hand, the majority (72-74%) had no problems in maintaining friendships and participating in community activities
more
Bhana A et al. Journal of the International AIDS Society 2021, 24(S2):e25713