Community health worker service delivery for maternal and child health: an observational study from Afghanistan

2021 ◽  
pp. archdischild-2021-322968
Author(s):  
Clare B Kelly ◽  
Shafiqullah Hemat ◽  
Malalai Naziri ◽  
Khaksar Yousufi ◽  
Karen M Edmond
Keyword(s):  
Pregnant Women ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Health Management ◽  
Population Based ◽  
Health Management Information System ◽  
The Mean ◽  
Using Data ◽  
Multivariable Regression Models

ObjectiveTo understand the reach of the community health worker (CHW) programme in remote and non-remote districts of Afghanistan.MethodsUsing data collected from the Ministry of Public Health’s National Health Management Information System, we conducted a population-based study from 2018 to 2019 in 401 districts across 34 provinces of Afghanistan. We assessed the availability of CHWs, antenatal visits (ANV) and postnatal visits (PNV) conducted by the CHWs, and the availability of CHW supplies. Districts were classified as remote if the district centre was >2 hours by any form of transport from provincial capital, and non-remote if <2 hours. Data were analysed using multivariable regression models.Results15 562 CHWs were working in the districts of Afghanistan, 13 482 (87%) in remote and 2080 (13%) in non-remote districts. The mean of the proportion of CHWs per pregnant woman was higher in remote (0.019 (SD 0.011)) compared with non-remote (0.012 (SD 0.006)) districts (adjusted mean difference (AMD) 0.008, 95% CI 0.004 to 0.01). The mean of the proportion of ANVs received from a CHW per pregnant women was higher in remote (0.88 (SD 0.82)) compared with non-remote (0.62 (SD 0.50)) districts (AMD 0.28, 95% CI 0.02 to 0.54). The mean of the proportion of PNVs received from a CHW per pregnant women was higher in remote (0.54 (SD 0.53)) compared with non-remote (0.36 (SD 0.25)) districts (AMD 0.19, 95% CI 0.02 to 0.36). The mean of the proportion of CHWs who reported that they had stocks of cotrimoxazole and oral contraceptives in the previous month per district was higher in remote compared with non-remote districts.ConclusionsIn Afghanistan, the CHW programme appears to be effective and proportionate to need in remote regions.

scholarly journals Post-Ebola Community Health Worker programme performance in Kenema District, Sierra Leone: A long way to go!

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 794
Author(s):  
Harold Thomas ◽  
Katrina Hann ◽  
Mohamed Vandi ◽  
Joseph Bengalie Sesay ◽  
Koi Sylvester Alpha ◽  
...  
Keyword(s):  
Community Health ◽  
Health Worker ◽  
Sierra Leone ◽  
Community Health Worker ◽  
Financial Incentives ◽  
Recovery Period ◽  
Positive Trend ◽  
District Health ◽  
Cross Sectional ◽  
The Mean

Background: The devastating 2014-2015 Ebola outbreak in Sierra Leone could erode the gains of the health system including the Community Health Worker (CHW) programme. We conducted a study to ascertain if the positive trend in reporting cases of malaria, pneumonia and diarrhoea treated by CHWs in the post-Ebola period has been sustained 18 months post-Ebola. Methods: We conducted a retrospective cross-sectional study using aggregated CHW programme data (2013-2017) from all Primary Health Units in Kenema district. Data was extracted from the District Health Information System and analysed using STATA. Data in the pre- (June 2013-April 2014), during- (June 2014-April 2015) and post-Ebola recovery (June 2016-April 2017) periods was compared and analysed for reporting completeness; Rapid Diagnostic Tests (RDTs) performed and cases of malaria, diarrhoea and pneumonia treated per month. Differences across periods were tested using two-sample t-test with significance set at 0.05. Results: CHW reporting increased from pre-Ebola by 8% (p-value=0.29) intra-Ebola and 19% (p-value=0.012) post-Ebola. Compared to the pre-Ebola period, in the post-Ebola recovery period, there was a significant increase in the mean monthly reported RDTs of 35% (p-value=0.020); malaria treatments 66% (p-value<0.001); and pneumonia treatments increased by 80% (p-value=0.004). Conversely, the mean monthly diarrhoea cases treated decreased by 20% (p-value=0.16) in the post-Ebola period. Conclusion: The resiliency demonstrated by the CHW programme during and immediately after the Ebola outbreak has been sustained in the post-Ebola recovery period. Continued programme investments in supportive supervision and financial incentives for CHWs will be critical to ensure uninterrupted contribution towards Sustainable Development Goal 3.

scholarly journals Post-Ebola Community Health Worker programme performance in Kenema District, Sierra Leone: A long way to go!

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 794
Author(s):  
Harold Thomas ◽  
Katrina Hann ◽  
Mohamed Vandi ◽  
Joseph Bengalie Sesay ◽  
Koi Sylvester Alpha ◽  
...  
Keyword(s):  
Community Health ◽  
Health Worker ◽  
Sierra Leone ◽  
Community Health Worker ◽  
Financial Incentives ◽  
Recovery Period ◽  
Positive Trend ◽  
District Health ◽  
Cross Sectional ◽  
The Mean

Background: The devastating 2014-2015 Ebola outbreak in Sierra Leone could erode the gains of the health system including the Community Health Worker (CHW) programme. We conducted a study to ascertain if the positive trend in reporting cases of malaria, pneumonia and diarrhoea treated by CHWs in the post-Ebola period has been sustained 18 months post-Ebola. Methods: We conducted a retrospective cross-sectional study using aggregated CHW programme data (2013-2017) from all Primary Health Units in Kenema district. Data was extracted from the District Health Information System and analysed using STATA. Data in the pre- (June 2013-April 2014), during- (June 2014-April 2015) and post-Ebola recovery (June 2016-April 2017) periods was compared and analysed for reporting completeness; Rapid Diagnostic Tests (RDTs) performed and cases of malaria, diarrhoea and pneumonia treated per month. Differences across periods were tested using two-sample t-test with significance set at 0.05. Results: CHW reporting increased from pre-Ebola by 8% (p-value=0.29) intra-Ebola and 19% (p-value=0.012) post-Ebola. Compared to the pre-Ebola period, in the post-Ebola recovery period, there was a significant increase in the mean monthly reported RDTs of 35% (p-value=0.020); malaria treatments 66% (p-value<0.001); and pneumonia treatments increased by 80% (p-value=0.004). Conversely, the mean monthly diarrhoea cases treated decreased by 20% (p-value=0.16) in the post-Ebola period. Conclusion: The resiliency demonstrated by the CHW programme during and immediately after the Ebola outbreak has been sustained in the post-Ebola recovery period. Continued programme investments in supportive supervision and financial incentives for CHWs will be critical to ensure uninterrupted contribution towards Sustainable Development Goal 3.

scholarly journals Community health worker-led ART delivery improved scheduled antiretroviral drug refill among men who have sex with men in Lagos State, Nigeria

2020 ◽  
Author(s):  
Olujuwon Ibiloye ◽  
Patrick Akande ◽  
Jwanle Plang ◽  
Franklin Emerenini ◽  
Temiwoluwa Omole ◽  
...  
Keyword(s):  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Retrospective Cohort ◽  
Routinely Collected Data ◽  
Antiretroviral Drug ◽  
Before And After ◽  
The Mean ◽  
Sex With Men ◽  
Art Delivery

Abstract Background Stigma affects access and treatment outcomes in men who have sex with men. We assessed the effect of novel community health worker-led antiretroviral therapy delivery (CLAD). Methods A retrospective cohort study of routinely collected data was conducted. We used the t-test to compare the mean adherence to scheduled drug refill appointments before and after implementing CLAD. Results The mean adherence to drug refill was 1.4 (±0.7 SD) of monthly scheduled refills before CLAD and 4.7 (±1.2 SD) of monthly refills in CLAD (P &lt; 0.001). Conclusion The CLAD model was more effective for drug refill appointments than a regular HIV clinic.

Addressing Mental Health and Stress in Medicaid-Insured Pregnant Women Using a Nurse-Community Health Worker Home Visiting Team

2007 ◽  
Vol 24 (3) ◽  
pp. 239-248 ◽  
Author(s):  
Lee Anne Roman ◽  
Judith K. Lindsay ◽  
Joseph S. Moore ◽  
Patricia A. Duthie ◽  
Christie Peck ◽  
...  
Keyword(s):  
Mental Health ◽  
Pregnant Women ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Home Visiting

scholarly journals Household coverage of Swaziland's national community health worker programme: a cross-sectional population-based study

2017 ◽  
Vol 22 (8) ◽  
pp. 1012-1020 ◽  
Author(s):  
Pascal Geldsetzer ◽  
Maria Vaikath ◽  
Jan-Walter De Neve ◽  
Thomas J. Bossert ◽  
Sibusiso Sibandze ◽  
...  
Keyword(s):  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Population Based ◽  
Cross Sectional ◽  
Population Based Study ◽  
National Community

Safe Start Community Health Worker Program: A Multisector Partnership to Improve Perinatal Outcomes Among Low-Income Pregnant Women With Chronic Health Conditions

2020 ◽  
Vol 110 (6) ◽  
pp. 836-839 ◽  
Author(s):  
Shayna D. Cunningham ◽  
Valerie Riis ◽  
Laura Line ◽  
Melissa Patti ◽  
Melissa Bucher ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Perinatal Outcomes ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
City Hospital ◽  
Chronic Health ◽  
Community Health Worker Program

Safe Start is a community health worker program representing a partnership between a high-volume, inner-city, hospital-based prenatal clinic; a community-based organization; a large Medicaid insurer; and a community behavioral health organization to improve perinatal outcomes among publicly insured pregnant women with chronic health conditions in Philadelphia, Pennsylvania. As of June 2019, 291 women participated in the program. Relative to a comparison group (n = 300), Safe Start participants demonstrate improved engagement in care, reduced antenatal inpatient admissions, and shorter neonatal intensive care unit stays.

scholarly journals What did the community health worker do that was helpful? Perceptions from patients with type 2 diabetes

2019 ◽  
Author(s):  
Connie H Yan ◽  
Aida Rodriguez ◽  
Ben S Gerber ◽  
Lisa K Sharp
Keyword(s):  
Type 2 Diabetes ◽  
African Americans ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Summative Evaluation ◽  
The Mean ◽  
Hispanic Latinos ◽  
Racial Ethnic

Abstract Background: Evidence supporting the effectiveness of community health worker (CHW) programs in improving type 2 diabetes mellitus (T2DM) outcomes is mixed. CHWs provide numerous activities; although, it is not clear what is effective or considered helpful by patients. This summative evaluation reports on patients’ perspectives of CHW activities offered as part of a larger randomized controlled trial of a team-based diabetes-management program. Methods: Following one-year of access to CHW support, 192 racial/ethnic minorities with uncontrolled T2DM were provided a two-item summative evaluation that assessed how helpful they found the CHWs, on a ten-point scale, along with an open-ended question about specific activities they found most helpful. Results: Patients’ mean age was 57 years, and 25% Hispanic/Latino, of which 47% preferred Spanish. The mean number of CHW visits was higher among Hispanics/Latinos compared to African-Americans (9.8, standard deviation [SD] 5.4 vs. 5.0, SD 4.7; p<0.001); however, perceived helpfulness was similar for both groups (Hispanic/Latinos 9.2, SD 1.5 vs. African-Americans 9.1, SD 1.9). Although the frequency of CHW visits was similar between Spanish- and English-speaking Hispanic/Latinos, the mean helpfulness rating was higher for Spanish-speakers than for English-speakers (9.6, SD 0.8 vs. 8.8, SD 1.8; p=0.05). After qualitative coding of the list of helpful activities, four major themes emerged: social support, health education, communication with the healthcare team and care coordination. Conclusion: This is among the first reports of differential CHW engagement within racial/ethnic groups. Additional research is needed to understand the relationship between CHW activities and mechanisms influencing outcomes.

Community health worker interventions for older adults with complex health needs: A systematic review

2021 ◽  
Author(s):  
Meaghan A. Kennedy ◽  
Kayla E. Hatchell ◽  
Peter R. DiMilia ◽  
Stephanie M. Kelly ◽  
Heather B. Blunt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Health Needs
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