The role of community health workers in the surgical cascade: a scoping review

Abstract Background Community health workers (CHWs) can increase access to various primary healthcare services; however, their potential for improving surgical care is under-explored. We sought to assess the role of CHWs in the surgical cascade, defined as disease screening, linkage to operative care, and post-operative care. Given the well-described literature on CHWs and screening, we focused on the latter two steps of the surgical cascade. Methods We conducted a scoping review of the peer-reviewed literature. We searched for studies published in any language from January 1, 2000 to May 1, 2020 using electronic literature databases including Pubmed/MEDLINE, Web of Science, SCOPUS, and Google Scholar. We included articles on CHW involvement in linkage to operative care and/or post-operative surgical care. Narrative and descriptive methods were used to analyze the data. Results The initial search identified 145 articles relevant to steps in the surgical cascade. Ten studies met our inclusion criteria and were included for review. In linkage to care, CHWs helped increase surgical enrollment, provide resources for vulnerable patients, and build trust in healthcare services. Post-operatively, CHWs acted as effective monitors for surgical-site infections and provided socially isolated patients with support and linkage to additional services. The complex and wide-ranging needs of surgical patients illustrated the need to view surgical care as a continuum rather than a singular operative event. Conclusion While the current literature is limited, CHWs were able to maneuver complex medical, cultural, and social barriers to surgical care by linking patients to counseling, education, and community resources, as well as post-operative infection prevention services. Future studies would benefit from more rigorous study designs and larger sample sizes to further elucidate the role CHWs can serve in the surgical cascade.

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The role of community health workers in addressing the global burden of ear disease and hearing loss: a systematic scoping review of the literature

BMJ Global Health ◽

10.1136/bmjgh-2018-001141 ◽

2019 ◽

Vol 4 (2) ◽

pp. e001141 ◽

Cited By ~ 17

Author(s):

James O'Donovan ◽

Misha Verkerk ◽

Niall Winters ◽

Shelly Chadha ◽

Mahmood F Bhutta

Keyword(s):

Hearing Loss ◽

Cost Effectiveness ◽

Community Health ◽

Community Health Workers ◽

Scoping Review ◽

Hearing Aids ◽

Low Income ◽

Health Workers ◽

Global Burden

IntroductionCommunity health workers (CHWs) have the potential to improve access to ear and hearing services for people across low-income or middle-income countries, remote, underserved, or resource-poor areas of the world. We performed a systematic scoping review to identify evidence on how CHWs are currently deployed in the prevention, screening, diagnosis, treatment and management of ear disease and hearing loss; methods to train and support CHWs in this context; and cost-effectiveness of CHWs.MethodsWe performed a systematic search of the literature from September 1978 to 18 March 2018 from 11 major databases and the grey literature.ResultsWe identified 38 original studies that met the inclusion criteria, taking place across South Asia (n=13), Oceania (n=7), North America (n=7), South America (n=6) and Africa (n=5). 23 studies showed CHWs can increase community participation in screening. They can conduct screening using whispered voice tests, noisemakers for neonatal screening, automated audiological tests and otoscopy. Eight studies focused specifically on the evaluation of programmes to train CHWs, and three provided a general programme description. Three studies documented a role of CHWs in the treatment of ear disease or hearing loss, such as performing ear washouts, instillation of topical antibiotics or fitting of hearing aids. Only one study provided an indepth cost-utility analysis regarding the use of CHWs to conduct hearing screening, and no studies commented on the role of CHWs in the prevention of hearing loss.ConclusionCHWs have been employed in diverse ways to address the global burden of ear disease and hearing loss. Future research needs to explore the role of CHWs in preventative strategies, identify optimum methods to train and support CHWs, and explore their cost-effectiveness.

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Role of community health workers in type 2 diabetes mellitus self-management: A scoping review

PLoS ONE ◽

10.1371/journal.pone.0198424 ◽

2018 ◽

Vol 13 (6) ◽

pp. e0198424 ◽

Cited By ~ 11

Author(s):

Bonaventure Amandi Egbujie ◽

Peter Arthur Delobelle ◽

Naomi Levitt ◽

Thandi Puoane ◽

David Sanders ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Community Health ◽

Community Health Workers ◽

Scoping Review ◽

Health Workers ◽

Self Management

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Exploring digital health interventions to support community health workers in low-and-middle-income countries during the COVID-19 pandemic: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2021-053871 ◽

2021 ◽

Vol 11 (9) ◽

pp. e053871

Author(s):

Anam Shahil Feroz ◽

Komal Valliani ◽

Hajra Khwaja ◽

Sehrish Karim

Keyword(s):

Community Health ◽

Community Health Workers ◽

Scoping Review ◽

Health Workers ◽

Digital Health ◽

Healthcare Services ◽

Health Interventions ◽

Cochrane Central Register ◽

Middle Income ◽

Middle Income Countries

IntroductionCOVID-19 has significantly affected community health workers’ (CHWs) performance as they are expected to perform pandemic-related tasks along with routine essential healthcare services. A plausible way to optimise CHWs’ functioning during this pandemic is to couple the efforts of CHWs with digital tools. So far, no systematic evidence is available on the use of digital health interventions to support CHWs in low-middle-income countries (LMICs) amid the COVID-19 pandemic. The article describes a protocol for a scoping review of primary research studies that aim to map evidence on the use of unique digital health interventions to support CHWs during COVID-19 in LMICs.Methods and analysisOur methodology has been adapted from scoping review guidelines provided by Arksey and O’Malley, Levac et al. and the Joanna Briggs Institute. Our search strategy has been developed for the following four main electronic databases: Excerpta Medica Database, Medical Literature Analysis and Retrieval System Online, Cochrane Central Register of Controlled Trials and Cumulated Index to Nursing and Allied Health Literature. Google Scholar and reference tracking will be used for supplementary searches. Each article will be screened against eligibility criteria by two independent researchers at the title and abstract and full-text level. The review will include studies that targeted digital health interventions at CHWs’ level to provide support in delivering COVID-19-related and other essential healthcare services. A date limit of 31 December 2019 to the present date will be placed on the search and English language articles will be included.Ethics and disseminationFormal ethical approval is not required, as primary data will not be collected in this study. The results from our scoping review will provide valuable insight into the use of digital health interventions to optimise CHWs’ functioning and will reveal current knowledge gaps in research. The results will be disseminated through journal publications and conference presentations.

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Post-trial perceptions of a symptom-based TB screening intervention in South Africa: implementation insights and future directions for TB preventive healthcare services

BMC Nursing ◽

10.1186/s12912-021-00544-z ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Nicole Salazar-Austin ◽

Minja Milovanovic ◽

Nora S. West ◽

Molefi Tladi ◽

Grace Link Barnes ◽

...

Keyword(s):

South Africa ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Implementation Strategies ◽

Healthcare Services ◽

Preventive Therapy ◽

Provider Perceptions ◽

Symptom Screening ◽

Study Implementation

Abstract Background Tuberculosis is a top-10 cause of under-5 mortality, despite policies promoting tuberculosis preventive therapy (TPT). We previously conducted a cluster randomized trial to evaluate the effectiveness of symptom-based versus tuberculin skin-based screening on child TPT uptake. Symptom-based screening did not improve TPT uptake and nearly two-thirds of child contacts were not identified or not linked to care. Here we qualitatively explored healthcare provider perceptions of factors that impacted TPT uptake among child contacts. Methods Sixteen in-depth interviews were conducted with key informants including healthcare providers and administrators who participated in the trial in Matlosana, South Africa. The participants’ experience with symptom-based screening, study implementation strategies, and ongoing challenges with child contact identification and linkage to care were explored. Interviews were systematically coded and thematic content analysis was conducted. Results Participants’ had mixed opinions about symptom-based screening and high acceptability of the study implementation strategies. A key barrier to optimizing child contact screening and evaluation was the supervision and training of community health workers. Conclusions Symptom screening is a simple and effective strategy to evaluate child contacts, but additional pediatric training is needed to provide comfort with decision making. New clinic-based child contact files were highly valued by providers who continued to use them after trial completion. Future interventions to improve child contact management will need to address how to best utilize community health workers in identifying and linking child contacts to care. Trial registration The results presented here were from research related to NCT03074799, retrospectively registered on 9 March 2017.

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Patient Navigation by Community Health Workers Increases Access to Surgical Care in Rural Haiti

World Journal of Surgery ◽

10.1007/s00268-017-4246-6 ◽

2017 ◽

Vol 41 (12) ◽

pp. 3025-3030 ◽

Cited By ~ 2

Author(s):

Alexi C. Matousek ◽

Stephen R. Addington ◽

Joseph Kahan ◽

Herriot Sannon ◽

Thelius Luckner ◽

...

Keyword(s):

Community Health ◽

Community Health Workers ◽

Patient Navigation ◽

Health Workers ◽

Surgical Care

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Exploring the Role of Community Health Workers in Providing Cancer Navigation: Perceptions of African American Older Adults

Oncology Nursing Forum ◽

10.1188/12.onf.e288-e298 ◽

2012 ◽

Vol 39 (3) ◽

pp. E288-E298 ◽

Cited By ~ 6

Author(s):

Jennifer Wenzel ◽

Randy Jones ◽

Rachel Klimmek ◽

Sarah Szanton ◽

Sharon Krumm

Keyword(s):

Older Adults ◽

African American ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

African American Older Adults

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Intimate Labor at Biomedical Frontlines: Situated Knowledges of Female Community Health Workers in the Management of COVID-19 in India

Catalyst Feminism Theory Technoscience ◽

10.28968/cftt.v7i1.34781 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Sanghamitra Das ◽

Samhita Das

Keyword(s):

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Medical Knowledge ◽

Healthcare Services ◽

Care Work ◽

Professional Status ◽

Public Healthcare ◽

The Public ◽

Female Community

Media reports of the COVID-19 pandemic in India have highlighted the important role that India’s female community health workers, the Accredited Social Health Activists (ASHAs), have played in managing COVID infections in India. This paper explores the epistemic basis of ASHA work to understand the significance of their role. Through a discourse analysis of textual media articles, we show that the ASHAs’ routine and COVID-related caregiving practices are a form of embodied, intimate labor rooted in their situated, community-oriented knowledge. This labor is devalued as emotional and feminized care work, which denies the ASHAs professional status in the public healthcare system of India and, in turn, reflects a hierarchy among health practitioners that stems from the status of objectivity/disembodiment in biomedicine. We find that, despite their low status in the public health system, ASHA workers develop a self-concept that enables them to self-identify as healthcare professionals, motivating them to continue providing essential healthcare services during the pandemic. We argue that an official recognition of the epistemic value of ASHA work would help to overcome the age-old nature/culture dichotomy that informs what counts as valuable, legitimate, formal medical knowledge. Furthermore, our analysis provides a critique of the gendered devaluation of care work within a political economy of health increasingly dictated by a neoliberal logic.

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Networking community health workers for service integration: role of social media

AIDS Care ◽

10.1080/09540121.2021.2019668 ◽

2022 ◽

pp. 1-7

Author(s):

Li Li ◽

Chunqing Lin ◽

Loc Quang Pham ◽

Diep Bich Nguyen ◽

Tuan Anh Le

Keyword(s):

Social Media ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Service Integration

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Abstract P303: Use of Community Health Workers for Community-based Hypertension Screening in Urban Haiti

Circulation ◽

10.1161/circ.141.suppl_1.p303 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Caleigh Smith ◽

Vanessa Rivera ◽

Jean Joscar Victor ◽

Lookens Pierre ◽

Fabyola Preval ◽

...

Keyword(s):

Blood Pressure ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Linkage To Care ◽

Median Number ◽

Population Based ◽

Age Group ◽

Cvd Risk ◽

Blood Pressure Screening

Background: Cardiovascular disease is the leading cause of mortality among Haitian adults, and hypertension (HTN) is the most important CVD risk factor, as in other resource-poor countries. The majority of Haitians have never been screened for hypertension and access to clinic-based services is limited. Methods: Twenty-eight Haitian community health workers (CHW) conducted household-based HTN screening within a population-based longitudinal cohort study of 3,000 adults in metropolitan Port-au-Prince. Randomly selected GPS locations across census blocks were selected in proportion to the estimated population of each block. One household at each waypoint was selected systematically and CHW collected household information and conducted three blood pressure measurements the same day on all adult household members (≥ 18 years) present at the time of the survey using AHA guidelines. Adults with HTN were referred to the GHESKIO clinic for repeat BP measurement and treatment. Results: Between March and September 2019, 585 households provided verbal consent for surveys and BP screening (97% response rate). These households had a total of 2542 people (1777 adults) with the median number of adults per household being 3 (IQR 2-4; range 1-9). A total of 913 adults (51%) were present at the time of survey, and all agreed to blood pressure screening. The majority were women (70%) with a median age of 36 years (IQR 27-52). Hypertension prevalence (SBP > 140 and/or DBP > 90) was 25.3% (15.5% Stage I, 9.8% Stage II). Figure 1 reports HTN prevalence by age group (18-30, 31-45, 46-60, >60) and by sex, with HTN increasing by age group but without significant variation by sex. Conclusion: Community blood pressure screening is feasible and highly acceptable in Port-au-Prince, Haiti. Preliminary results show high rates of HTN among a population with limited access to screening, diagnosis and treatment. Further research is urgently needed to design linkage to care strategies and effective treatment interventions to curb the HTN epidemic in Haiti.

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