scholarly journals Integrating community health volunteers into non-communicable disease management among Syrian refugees in Jordan: a causal loop analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045455
Author(s):  
Parveen K Parmar ◽  
Fatma Rawashdah ◽  
Nahla Al-Ali ◽  
Raeda Abu Al Rub ◽  
Muhammad Fawad ◽  
...  
Keyword(s):  
Community Health ◽  
Low Income ◽  
Health Workers ◽  
Communicable Disease ◽  
Blood Pressure Measurement ◽  
Syrian Refugees ◽  
Loop Analysis ◽  
Causal Loop ◽  
Community Health Volunteers ◽  
Management Of Complications

ObjectivesGlobally, there is emerging evidence on the use of community health workers and volunteers in low-income and middle-income settings for the management of non-communicable diseases (NCDs), provision of out-of-clinic screening, linkage with health services, promotion of adherence, and counselling on lifestyle and dietary changes. Little guidance exists on the role of this workforce in supporting NCD care for refugees who lack access to continuous care in their host country. The goals of this work were to evaluate the current roles of community health volunteers (CHVs) in the management of diabetes and hypertension (HTN) among Syrian refugees and to suggest improvements to the current primary care model using community health strategies.Setting and participantsA participatory, multistakeholder causal loop analysis workshop with representatives from the Ministry of Health of Jordan, non-governmental organisations, United Nations agencies, CHVs and refugee patients was conducted in June 2019 in Amman, Jordan.Primary outcomeThis causal loop analysis workshop was used to collaboratively develop a causal loop diagram and CHV strategies designed to improve the health of Syrian refugees with diabetes and HTN living in Jordan.ResultsDuring the causal loop analysis workshop, participants collaboratively identified and mapped how CHVs might improve care among diagnosed patients. Possibilities identified included the following: providing psychosocial support and foundational education on their conditions, strengthening self-management of complications (eg, foot checks), and monitoring patients for adherence to medications and collection of basic health monitoring data. Elderly refugees with restricted mobility and/or uncontrolled disease were identified as a key population where CHVs could provide home-based blood glucose and blood pressure measurement and targeted health education to provide more precise monitoring.ConclusionsCHV programmes were cited as a key strategy to implement secondary prevention of morbidity and mortality among Syrian refugees, particularly those at high risk of decompensation.

scholarly journals Impact of Different Levels of Supervision on the Recovery of Severely Malnourished Children Treated by Community Health Workers in Mali

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 367
Author(s):  
Pilar Charle-Cuéllar ◽  
Noemí López-Ejeda ◽  
Mamadou Traore ◽  
Adama Balla Coulibaly ◽  
Aly Landouré ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Community Intervention ◽  
Health Workers ◽  
Acute Malnutrition ◽  
Control Group ◽  
Supportive Supervision ◽  
Supervision Group ◽  
Different Levels

(1) Background: The Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated community case management (iCCM). This paper evaluates the most effective model of supervision for treating SAM using community health workers (CHWs). Methods (2): This study was a prospective non-randomized community intervention trial with two intervention groups and one control group with different levels of supervision. It was conducted in three districts in rural areas of the Kayes Region. In the high supervision group, CHWs received supportive supervision for the iCCM package and nutrition-specific supervision. In the light supervision group, CHWs received supportive supervision based on the iCCM package. The control group had no specific supervision. (3) Results: A total of 6112 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 81.4% in those treated by CHWs in the high supervision group, 86.2% in the light supervision group, and 66.9% in the control group. Children treated by the CHWs who received some supervision had better outcomes than those treated by unsupervised CHWs (p < 0.001). There was no difference between areas with light and high supervision, although those with high supervision performed better in most of the tasks analyzed. (4) Conclusions: Public policies in low-income countries should be adapted, and their model of supervision of CHWs for SAM treatment in the community should be evaluated.

scholarly journals Ongoing training of community health workers in low-income andmiddle-income countries: a systematic scoping review of the literature

BMJ Open ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. e021467 ◽  
Author(s):  
James O’Donovan ◽  
Charles O’Donovan ◽  
Isla Kuhn ◽  
Sonia Ehrlich Sachs ◽  
Niall Winters
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Scoping Review ◽  
Low Income ◽  
Health Workers ◽  
Review Of The Literature ◽  
Ongoing Training

scholarly journals Strategies Used By Community Health Workers to Influence Adoption of Maternal Nutrition Behaviors in Rural Bangladesh: A Focused Ethnographic Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1359-1359
Author(s):  
Gargi Wable Grandner ◽  
Katherine Dickin ◽  
Purnima Menon ◽  
Tiffany Yeh ◽  
John Hoddinott
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Maternal Nutrition ◽  
Health Workers ◽  
Ethnographic Study ◽  
Low Income Countries ◽  
Cultural Congruence ◽  
Healthy Tree ◽  
Diet Diversity

Abstract Objectives Efforts to integrate nutrition into antenatal health promotion in low income countries have led to increased involvement of community health workers (CHWs) in counseling on maternal nutrition. Little is known about how CHWs “package” messages in resource-poor communities to increase adoption of recommended maternal nutrition behaviors. We developed focused ethnographic techniques to explore this. Methods We interviewed 35 randomly selected CHWs providing monthly counseling to pregnant women and their families in 7 ‘Alive & Thrive’ intervention sites in Bangladesh. Two sorting exercises explored CHW strategies for promoting and perceptions of adoption of messages on micronutrient supplements, maternal dietary adequacy, and rest during pregnancy. In-depth probing on messages identified as “difficult” to deliver or adopt revealed how CHWs addressed barriers. Analysis of quantitative sorting data complemented thematic coding of qualitative textual data using grounded theory. Results CHW communication strategies involved 3 themes: feasibility (attitudes, norms, agency, poverty), audience (influence, motivators, support), and linguistic choice (emotional appeals, metaphors, logic, sellable but inaccurate arguments). CHWs viewed micronutrient messages as least difficult to adopt, requiring minimal “packaging”. Dietary messages were moderately difficult to adopt, prompting CHWs to leverage cultural congruence to target family members with different strategies. For example, messaging on diet diversity targeted husbands—the primary food-buyers—with logical arguments highlighting costs of inaction. When mothers-in-law held beliefs restricting gestational food intake, CHWs used metaphors (‘healthy tree, healthy fruit’) or faith-based appeals. Some CHWs used inaccurate messages (‘mother rests, baby rests’) to promote rest during pregnancy because it was seen as the least feasible behavior to adopt. Conclusions Where behavior change is viewed as feasible, CHWs use culturally resonant strategies to enhance adoption of maternal nutrition behaviors. Cultural congruence, or shared beliefs, language and cultural identity, is key to CHW effectiveness, but unhelpful for contextually infeasible behaviors. BCC programs co-designed with CHWs could improve messaging and effectiveness. Funding Sources Cornell AWARE Travel Grant.

Assessing community health workers’ conditions for delivering care to patients in low-income communities

2020 ◽  
Vol 82 ◽  
pp. 102944 ◽  
Author(s):  
Alessandro Jatobá ◽  
Hugo Cesar Bellas ◽  
Bárbara Bulhões ◽  
Isabella Koster ◽  
Rodrigo Arcuri ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Health Workers

scholarly journals Screening and Referral for Postpartum Depression among Low-Income Women: A Qualitative Perspective from Community Health Workers

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Rhonda C. Boyd ◽  
Marjie Mogul ◽  
Deena Newman ◽  
James C. Coyne
Keyword(s):  
Mental Health ◽  
Postpartum Depression ◽  
Focus Groups ◽  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Health Workers ◽  
Academic Community ◽  
Barriers And Facilitators ◽  
Postpartum Women

Postpartum depression is a serious and common psychiatric illness. Mothers living in poverty are more likely to be depressed and have greater barriers to accessing treatment than the general population. Mental health utilization is particularly limited for women with postpartum depression and low-income, minority women. As part of an academic-community partnership, focus groups were utilized to examine staff practices, barriers, and facilitators in mental health referrals for women with depression within a community nonprofit agency serving low-income pregnant and postpartum women. The focus groups were analyzed through content analyses and NVIVO-8. Three focus groups with 16 community health workers were conducted. Six themes were identified: (1) screening and referral, (2) facilitators to referral, (3) barriers to referral, (4) culture and language, (5) life events, and (6) support. The study identified several barriers and facilitators for referring postpartum women with depression to mental health services.

scholarly journals Counseling at all contacts for postpartum contraceptive use: can paper-based tools help community health workers improve continuity of care? A qualitative study from Ethiopia

2019 ◽  
Vol 3 ◽  
pp. 1652 ◽  
Author(s):  
Muluneh Yigzaw Mossie ◽  
Anne Pfitzer ◽  
Yousra Yusuf ◽  
China Wondimu ◽  
Eva Bazant ◽  
...  
Keyword(s):  
Decision Making ◽  
Health System ◽  
Community Health ◽  
Low Income ◽  
Health Workers ◽  
Continuum Of Care ◽  
Low Income Countries ◽  
Health Extension Workers ◽  
Pregnancy Risk ◽  
The Continuum

Background: Globally, there has been a resurgence of interest in postpartum family planning (PPFP) to advance reproductive health outcomes. Few programs have systematically utilized all contacts a woman and her baby have with the health system, from pregnancy through the first year postpartum, to promote PPFP. Nested into a larger study covering two districts, this study assessed the use, acceptability, and feasibility of tools for tracking women’s decision-making and use of PPFP in the community health system in Oromia region, Ethiopia. Community-level tracking tools included a modified Integrated Maternal and Child Health (IMCH) card with new PPFP content, and a newly developed tool for pregnant and postpartum women for use by Women Development Armies (WDAs). Proper completion of the tools was monitored during supervision visits. Methods: In-depth interviews and focus group discussions were conducted with health officials, health extension workers, and volunteers. A total of 34 audio-files were transcribed and translated into English, double-coded using MAXQDA, and analyzed using a thematic approach. Results: The results describe how HEWs used the modified IMCH card to track women’s decision making through the continuum of care, to assess pregnancy risk and to strengthen client-provider interaction. Supervision data demonstrated how well HEWs completed the modified IMCH card. The WDA tool was intended to promote PPFP and encourage multiple contacts with facilities from pregnancy to extended postpartum period. HEWs have reservations about the engagement of WDAs and their use of the WDA tool. Conclusions: To conclude, the IMCH card improves counseling practices through the continuum of care and is acceptable and feasible to apply. Some elements have been incorporated into a revised national tool and can serve as example for other low-income countries with similar community health systems. Further study is warranted to determine how to engage WDAs in promoting PPFP.

scholarly journals How Do The Community Health Nurses’ Experience in The Strategies of Non-Communicable Disease (NCD) Promotion and Prevention?

2021 ◽  
Vol 9 (1) ◽  
pp. 13-32
Author(s):  
Rizkiyani Istifada ◽  
Etty Rekawati ◽  
Wiwin Wiarsih
Keyword(s):  
Health Services ◽  
Community Health ◽  
Health Center ◽  
Health Workers ◽  
Communicable Disease ◽  
Community Health Center ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
Community Health Nurses ◽  
Individual Health Services

Nurses have an important task in the strategy of intervention to reduce of Non-Communicable Diseases (NCD)’ incidence. Community health nurses have tried to control the problem of NCD. However, the incidence of NCD has not decreased as expected. The promotion and prevention of non-communicable diseases are one of the efforts to control PTM. This study aims to explore the experience of nurses in implementing the strategies of NCD’ promotive and preventive. This study used a qualitative descriptive phenomenological design. A total of 16 community health nurses were selected using purposive sampling. The inclusion criteria of this study were (1) nurses who served at the community health center for a minimum of 6 months, (2) performed individual health services in the community health center and carried out family visits and services in the community. The data were analyzed using Colaizzi's approach. This research was approved by the Committee of Ethics in the Faculty of Nursing, Universitas Indonesia. This study resulted in five strategies of nurses implementing to NCD’ promotion and prevention, include (1) health education, (2) partnership with community health workers, (3) coordination, (4) stand with the community, (5) monitoring the change of behavior in the community. Nurses’ experience of NCD’s promotion and prevention in the community health center still needs improvement to achieve holistic and comprehensive health services. Nurses should be attention to the preparation of themselves before implementing the promotion and prevention, such as preparation of the topic, communication with colleagues and communities, and doing a partnership with multisectoral.

scholarly journals Factors Affecting the Performance of Community Health Workers at the Integrated Non Communicable Disease Health Post in Karanganyar, Central Java

2020 ◽  
Author(s):  
Eka Siti Chasanah ◽  
◽  
Endang Sutisna Sulaeman ◽  
etyo Sri Rahardjo ◽  
◽  
...  
Keyword(s):  
Social Support ◽  
Community Health ◽  
Health Workers ◽  
Communicable Disease ◽  
Health Post ◽  
Factors Affecting ◽  
Central Java ◽  
Integrated Health ◽  
High Motivation ◽  
Non Communicable Disease

ABSTRACT Background: Health workers (cadre) play role in controlling non-communicable disease by promoting people to participate in any integrated health posts (posbindu) activities. This study aimed to examine factors affecting the performance of community health workers at the integrated non communicable disease health post in Karanganyar, Central Java. Subjects and Method: A cross sectional study was carried out at 25 integrated health posts (posbindu) in Karanganyar, Central Java. A sample of 200 cadres was selected by stratified random sampling. The dependent variables were cadre performance. The independent variables were motivation, leadership, social support, skill, and tenure. The data were collected by questionnaire and analyzed by a multiple logistic regression run on Stata 13. Results: Cadre performance increased with high motivation (OR= 6.15; 95% CI= 2.75 to 13.76; p<0.001), good leadership (OR= 2.24; 95% CI= 1.04 to 4.83; p= 0.039), strong social support (OR= 3.62; 95% CI= 1.68 to 7.80; p=0.001), good skill (OR= 5.56; 95% CI= 2.40 to 12.86; p<0.001), had trained (OR= 2.42; 95% CI= 0.91 to 6.42; p= 0.076), and tenure ≥1 year (OR= 5.56; 95% CI= 2.40 to 12.86; p<0.001). Conclusion: Cadre performance increases with high motivation, good leadership, strong social support, good skill, had trained, and tenure ≥1 year. Keywords: cadre performance, non-communicable disease, integrated health post Correspondence: Eka Siti Chasanah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6281329017587. DOI: https://doi.org/10.26911/the7thicph.04.45

scholarly journals Risk Behavior for Falls in the Elderly: Experiences of Community Health Workers

Aquichan ◽  
2020 ◽  
Vol 20 (2) ◽  
pp. 1-11
Author(s):  
Renata Francielle Melo dos Reis Fonseca ◽  
Silvia Matumoto ◽  
Joab Jefferson da Silva Xavier ◽  
Jossiane Wilke Faller
Keyword(s):  
Community Health ◽  
Risk Behaviors ◽  
Community Health Workers ◽  
Low Income ◽  
Health Workers ◽  
Elderly Person ◽  
The Elderly ◽  
Extrinsic Factors ◽  
Related Factors ◽  
Study Results

Objective: To identify the risk behaviors of the elderly at home, described by community health workers, and related factors. Materials and methods: Qualitative research, in the dialectical perspective, carried out through a focus group with community health workers from a family health strategy unit in a municipality of the State of São Paulo, Brazil. Thematic content analysis was used for the study. Results: The revealed risk behaviors are related to extrinsic factors (architecture, furniture, and equipment), socioeconomic factors (low income, level of education, deficit of social and a family support), and psychological factors (feeling of vulnerability, dependence and not self-acknowledging in a dangerous condition). Conclusions: Falls are the result of a complex interaction between the factors and, the behaviors studied so that adequate identification of these can subsidize individual and collective intervention actions, as well as care management and planning processes aimed at the health of the elderly person.

scholarly journals Community health workers at the dawn of a new era

2021 ◽  
Vol 19 (S3) ◽  
Author(s):  
Joseph M. Zulu ◽  
Henry B. Perry
Keyword(s):  
Community Health ◽  
Population Health ◽  
Community Health Workers ◽  
Low Income ◽  
Large Scale ◽  
Health Workers ◽  
The United States ◽  
Noncommunicable Diseases ◽  
Full Potential ◽  
New Era

Abstract Background There is now rapidly growing global awareness of the potential of large-scale community health worker (CHW) programmes not only for improving population health but, even more importantly, for accelerating the achievement of universal health coverage and eliminating readily preventable child and maternal deaths. However, these programmes face many challenges that must be overcome in order for them to reach their full potential. Findings This editorial introduces a series of 11 articles that provide an overview highlighting a broad range of issues facing large-scale CHW programmes. The series addresses many of them: planning, coordination and partnerships; governance, financing, roles and tasks, training, supervision, incentives and remuneration; relationships with the health system and communities; and programme performance and its assessment. Above all, CHW programmes need stronger political and financial support, and this can occur only if the potential of these programmes is more broadly recognized. The authors of the papers in this series believe that these challenges can and will be overcome—but not overnight. For this reason, the series bears the title “Community Health Workers at the Dawn of a New Era”. The scientific evidence regarding the ability of CHWs to improve population health is incontrovertible, and the favourable experience with these programmes at scale when they are properly designed, implemented, and supported is compelling. CHW programmes were once seen as a second-class solution to a temporary problem, meaning that once the burden of disease from maternal and child conditions and from communicable diseases in low-income countries had been appropriately reduced, there would be no further need for CHWs. That perspective no longer holds. CHW programmes are now seen as an essential component of a high-performing healthcare system even in developed countries. Their use is growing rapidly in the United States, for instance. And CHWs are also now recognized as having a critically important role in the control of noncommunicable diseases as well as in the response to pandemics of today and tomorrow in all low-, middle-, and high-income countries throughout the world. Conclusion The promise of CHW programmes is too great not to provide them with the support they need to achieve their full potential. This series helps to point the way for how this support can be provided.

Sign in / Sign up

Export Citation Format

Share Document