Recommended actions and international and national level
DHS Working Papers No. 108 | Zimbabwe Working Papers
No. 9
Informal health workers are important care providers in the region and continue to be so during the current Ebola Virus Disease (EVD) outbreak. Many are well respected and trusted members of the community who can mobilise large numbers of people for a particular activity and lend legitimacy to a par...ticular programme.
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22nd edition
The purpose of the SAHR has always been to analyse and assess progress and challenges in key areas of the health system, and to propose recommendations for improvement. We are pleased to continue this tradition in the 2019 edition, which presents a unique collection of perspectives on ...the key challenges in implementing universal health coverage (UHC) in South Africa, as analysed by experts in various fields.
Each of the 20 chapters deals with aspects of the UHC journey, dedicated towards an equitable and inclusive national health system that leaves no-one behind. While some authors describe the fundamental changes and practical considerations required to reconfigure the country's health system, others have reflected on specific programmatic areas and have made recommendations from a National Health Insurance (NHI)/UHC lens.
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Integritas 4.3 (Fall 2014), pp. 1-30.
doi: 10.6017/integritas.v4i3p1
Men are less likely than women to seek help for mental health issues and are much more likely to commit suicide. This scoping review examined recent evidence published in English and Russian on the role of socially constructed masculinity norms in men’s help-seeking behaviour for mental health iss...ues. The key sociocultural barriers to men’s help-seeking pertaining to masculinity norms were identified as self-reliance, difficulty in expressing emotions and self-control.
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The health impact of radiological and nuclear emergencies can last for decades. Lessons learned from past radiological and nuclear accidents have demonstrated that the mental health and psychosocial consequences can outweigh the direct physical health impacts of radiation exposure. International rad...iation emergency preparedness and response standards outline provisions for mitigating these effects. Yet, practical guidance for addressing the mental health and psychosocial aspects of radiation emergencies remains scarce.
This framework aims to promote integration between the MHPSS and radiation protection fields. It is intended for officials and specialists involved in radiation emergency planning and risk management as well as MHPSS experts working in health emergencies.
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Measuring progress towards universal health coverage.
This sixth edition of Health at a Glance Asia/Pacific presents a set of key indicators of health status, the determinants of health, health care resources and utilisation, health care expenditure and financing and quality of care across 27 Asia-...Pacific countries and territories. It also provides a series of dashboards to compare performance across countries and territories, and a thematic analysis on the impact of the COVID-19 outbreak on Asia/Pacific health systems.
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Background paper 8
The Independent Panel for Pandemic Preparedness and Response
May 2021
Guide to national implementation of the Shanghai Declaration describes policy orientations and approaches that can unlock the transformative potential of health promotion for sustainable development. This guide was developed to support country level implementation of the commitments and recommendati...ons in the Shanghai Declaration.
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This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major cha...llenge in large-scale CHW programmes is the need for CHWs to establish and maintain benefcial relationships with both sets of actors, who may have diferent expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities.
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Les modules de formation et d’orientation QualityRights ont été élaborés pour renforcer les connaissances, les compétences et la compréhension des principales parties prenantes sur la manière de promouvoir les droits des personnes en situation de handicap psychosocial, intellectuel ou cogni...tif, d'améliorer la qualité des services et des aides fournis dans le domaine de la santé mentale et dans les domaines connexes, conformément aux normes internationales en matière de droits humains, et en particulier la Convention des Nations unies relative aux droits des personnes handicapées et l'approche du rétablissement.
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This report includes six case studies from 12 individuals with lived experience of diverse health conditions. These case studies explore the topics of power dynamics and power reorientation towards individuals with lived experience; informed decision-making and health literacy; community engagement ...across broader health networks and health systems; lived experience as evidence and expertise; exclusion and the importance of involving groups that are marginalized; and advocacy and human rights.
It is the first publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives,inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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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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