The Role of Community Health Workers in HIV Care Engagement

This commentary discusses the different roles of community health workers (CHWs), their challenges and limitations in a historical perspective of primary health care (PHC). We first try to show that the comprehensive philosophy of PHC promulgated in Alma-Ata proposed the role of CHWs as actors who work in community development. On the other hand, in the 1980s, with the emergence of the selective philosophy of PHC, CHWs’ role was more affiliated with the health system. We conclude our pitch about the balance that can exist between these different roles by suggesting that CHWs can work in continuity with the health system, but they should not be considered as affordable labor. Also, they must be supported in their activities to develop their communities, allowing them to participate effectively in programs and policies that concern them and their community.

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Community perceptions and attitudes on malaria case management and the role of community health workers

Malaria Journal ◽

10.1186/s12936-017-1916-7 ◽

2017 ◽

Vol 16 (1) ◽

Cited By ~ 6

Author(s):

Collins J. Owek ◽

Elizabeth Oluoch ◽

Juddy Wachira ◽

Benson Estambale ◽

Yaw A. Afrane

Keyword(s):

Case Management ◽

Community Health ◽

Community Health Workers ◽

Malaria Case ◽

Health Workers ◽

Community Perceptions ◽

Malaria Case Management ◽

Perceptions And Attitudes

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Delivering comprehensive HIV services across the HIV care continuum: a comparative analysis of survival and progress towards 90-90-90 in rural Malawi

BMJ Global Health ◽

10.1136/bmjgh-2017-000552 ◽

2018 ◽

Vol 3 (1) ◽

pp. e000552 ◽

Cited By ~ 5

Author(s):

Emily B Wroe ◽

Elizabeth L Dunbar ◽

Noel Kalanga ◽

Luckson Dullie ◽

Chiyembekezo Kachimanga ◽

...

Keyword(s):

Community Health ◽

Social Determinants Of Health ◽

Community Health Workers ◽

Health Systems ◽

Social Determinants ◽

Health Workers ◽

Hiv Care ◽

Hiv Care Continuum ◽

Care Continuum ◽

Facility Level

IntroductionPartners In Health and the Malawi Ministry of Health collaborate on comprehensive HIV services in Neno, Malawi, featuring community health workers, interventions addressing social determinants of health and health systems strengthening. We conducted an observational study to describe the HIV care continuum in Neno and to compare facility-level HIV outcomes against health facilities nationally.MethodsWe compared facility-level outcomes in Neno (n=13) with all other districts (n=682) from 2013 to 2015 using mixed-effects linear regression modelling. We selected four outcomes that are practically useful and roughly mapped on to the 90-90-90 targets: facility-based HIV screenings relative to population, new antiretroviral therapy (ART)enrolments relative to population, 1-year survival rates and per cent retained in care at 1 year.ResultsIn 2013, the average number of HIV tests performed, as a per cent of the adult population, was 11.75%, while the average newly enrolled patients was 10.03%. Percent receiving testing increased by 4.23% over 3 years (P<0.001, 95% CI 2.98% to 5.49%), while percent enrolled did not change (P=0.28). These results did not differ between Neno and other districts (P=0.52), despite Neno having a higher proportion of expected patients enrolled. In 2013, the average ART 1-year survival was 80.41% nationally and 91.51% in Neno, which is 11.10% higher (P=0.002, 95% CI 4.13% to 18.07%). One-year survival declined by 1.75% from 2013 to 2015 (P<0.001, 95% CI −2.61% to −0.89%); this was similar in Neno (P=0.83). Facility-level 1-year retention was 85.43% nationally in 2013 (P<0.001, 95% CI 84.2% to 86.62%) and 12.07% higher at 97.50% in Neno (P=0.001, 95% CI 5.08% to19.05%). Retention declined by 2.92% (P<0.001, 95% CI −3.69% to −2.14%) between 2013 and 2015, both nationally and in Neno.ConclusionThe Neno HIV programme demonstrated significantly higher survival and retention rates compared with all other districts in Malawi. Incorporating community health workers, strengthening health systems and addressing social determinants of health within the HIV programme may help Malawi and other countries accelerate progress towards 90-90-90.

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The Role of Community Health Workers in Maternal and Child Health Surveillance to Optimize Maternal and Child Health in Pasuruan District, East Java

10.26911/thejhpm.2017.02.02.04 ◽

2017 ◽

Vol 02 (02) ◽

pp. 128-136

Author(s):

Ninil Dwi Pangestu ◽

◽

Hermanu Joebagio ◽

Setyo Sri Rahardjo ◽

◽

...

Keyword(s):

Child Health ◽

Community Health ◽

Community Health Workers ◽

Maternal And Child Health ◽

Health Workers ◽

Health Surveillance ◽

Child Health Surveillance ◽

And Child Health

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Role of home visits by volunteer community health workers: to improve the coverage of micronutrient powders in rural Bangladesh

Public Health Nutrition ◽

10.1017/s1368980020000038 ◽

2020 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Haribondhu Sarma ◽

Mduduzi NN Mbuya ◽

Md Tariqujjaman ◽

Mahfuzur Rahman ◽

Sufia Askari ◽

...

Keyword(s):

Community Health ◽

Community Health Workers ◽

Home Visit ◽

Health Workers ◽

Home Visits ◽

Cross Sectional ◽

Effective Coverage ◽

Micronutrient Powder ◽

Independent Effects

Abstract Objective: We assessed the role of home visits by Shasthya Shebika (SS) – female volunteer community health workers (CHWs) – in improving the distribution of micronutrient powder (MNP), and explored the independent effects of caregiver–provider interaction on coverage variables. Design: We used data from three cross-sectional surveys undertaken at baseline (n 1927), midline (n 1924) and endline (n 1540) as part of an evaluation of a home fortification programme. We defined an exposure group as one that had at least one SS visit to the caregiver’s household in the 12 months preceding the survey considering three outcome variables – message (ever heard), contact (ever used) and effective coverage (regular used) of MNP. We performed multiple logistic regressions to explore the determinants of coverage, employed an ‘interaction term’ and calculated an odds ratio (OR) to assess the modifying effect of SS’s home visits on coverage. Settings: Sixty-eight sub-districts from ten districts of Bangladesh. Participants: Children aged 6–59 months and their caregivers. Results: A home visit from an SS positively impacts message coverage at both midline (ratio of OR 1·70; 95 % CI 1·25, 2·32; P < 0·01) and endline (ratio of OR 3·58; 95 % CI 2·22, 5·78; P < 0·001), and contact coverage both at midline (ratio of OR 1·48; 95 % CI 1·06, 2·07; P = 0·021) and endline (ratio of OR 1·74; 95 % CI 1·23, 2·47; P = 0·002). There was no significant effect of a SS’s home visit on effective coverage. Conclusions: The households visited by BRAC’s volunteer CHWs have better message and contact coverage among the children aged 6–59 months.

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