scholarly journals Adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis

2021 ◽  
Vol 15 (2) ◽  
pp. e0008989
Author(s):  
Luisa Rubiano ◽  
Neal D. E. Alexander ◽  
Ruth Mabel Castillo ◽  
Álvaro José Martínez ◽  
Jonny Alejandro García Luna ◽  
...  
Keyword(s):  
Health Services ◽  
Community Health ◽  
Cutaneous Leishmaniasis ◽  
Mobile Application ◽  
Health Workers ◽  
Prediction Rule ◽  
Case Detection ◽  
Access To Health Services ◽  
Community Health Volunteers ◽  
Access To Health

Background Detection and management of neglected tropical diseases such as cutaneous leishmaniasis present unmet challenges stemming from their prevalence in remote, rural, resource constrained areas having limited access to health services. These challenges are frequently compounded by armed conflict or illicit extractive industries. The use of mobile health technologies has shown promise in such settings, yet data on outcomes in the field remain scarce. Methods We adapted a validated prediction rule for the presumptive diagnosis of CL to create a mobile application for use by community health volunteers. We used human-centered design practices and agile development for app iteration. We tested the application in three rural areas where cutaneous leishmaniasis is endemic and an urban setting where patients seek medical attention in the municipality of Tumaco, Colombia. The application was assessed for usability, sensitivity and inter-rater reliability (kappa) when used by community health volunteers (CHV), health workers and a general practitioner, study physician. Results The application was readily used and understood. Among 122 screened cases with cutaneous ulcers, sensitivity to detect parasitologically proven CL was >95%. The proportion of participants with parasitologically confirmed CL was high (88%), precluding evaluation of specificity, and driving a high level of crude agreement between the app and parasitological diagnosis. The chance-adjusted agreement (kappa) varied across the components of the risk score. Time to diagnosis was reduced significantly, from 8 to 4 weeks on average when CHV conducted active case detection using the application, compared to passive case detection by health facility-based personnel. Conclusions Translating a validated prediction rule to a mHealth technology has shown the potential to improve the capacity of community health workers and healthcare personnel to provide opportune care, and access to health services for underserved populations. These findings support the use of mHealth tools for NTD research and healthcare.

scholarly journals Community Health Workers: Challenges and Vulnerabilities of Accredited Social Health Activists Working in Conflict-affected Settings in the State of Assam, India

2020 ◽  
Author(s):  
Preety R Rajbangshi ◽  
Devaki Nambiar ◽  
Aradhana Srivast
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Social Relations ◽  
Health Workers ◽  
Social Health ◽  
Access To Health Services ◽  
North East ◽  
The North ◽  
East Region ◽  
Access To Health

Abstract Introduction:. It is well acknowledged that India’s Community Health workers known as Accredited Social Health Activists (ASHA) are the bedrock of its health system. Many ASHAs are currently working in fragile and conflict-affected settings. No efforts have yet been made to understand the challenges and vulnerabilities of these female workers. This paper seeks to address this gap by bringing attention to the situation of ASHAs working in the fragile and conflict settings and how conflict impacts them and their work. Methods: Qualitative fieldwork was undertaken in four conflict-affected villages in two conflict-affected districts -Kokrajhar and Karbi Anglong of Assam state situated in the North-East region of India. Detailed account of four ASHAs from the majority (Bodo or Karbi) and minority (Adivasi or Koch) communities serving roughly 4000 people is presented. Data transliterated into English were analysed by authors by developing a codebook using grounded theory and thematic organisation of codes. Results: ASHAs reported facing challenges in ensuring access to health services during and immediately after outbreaks of conflict. They experienced difficulty in arranging transport and breakdown of services at remote health facilities. Their physical safety and security were at risk during episodes of conflict. ASHAs reported hostile attitudes of the communities they served due to the breakdown of social relations, trauma due to displacement, and loss of family members, particularly their husbands. Conclusion: Conflict must be recognised as an important context within which community health workers operate, with greater policy focus and research devoted to understanding and addressing the barriers they face as workers and as persons affected by conflict.

scholarly journals Design of Mobile Application for Community Health Workers: A Case Study in Rwanda

2020 ◽  
Vol 14 (11) ◽  
pp. 271
Author(s):  
Gahizi Emmanuel ◽  
Andi Wahju Rahardjo Emanuel ◽  
Djoko Budiyanto Setyohadi
Keyword(s):  
Public Health ◽  
Health Services ◽  
Community Health ◽  
Community Health Workers ◽  
Human Service ◽  
Mobile Application ◽  
Health Workers ◽  
User Centered Design ◽  
Public Health Services ◽  
Adequate Knowledge

Community health workers (CHWs) are the basis of public health services that aim to connect the gap between public health and the human service system. This gap can be completely bridged by navigating the health and human service systems and educating communities on disease prevention. Unfortunately, the way of sharing, accessing information, and delivering health services is still non-digitalized in Rwanda. Community Health workers use a manual system in their daily activities, which is prone to error and falsification. Moreover, these people selected to perform these activities often do not have adequate knowledge about diseases and health systems since they are not professional health workers. To address the above problem, we designed a prototype mobile application to enable these workers to automatically submit reports, transfer knowledge, share information, and receive training from professionals.  The design process followed a User-Centered Design approach to meet the users’ requirements. The evaluation of the design showed that 91.7% of the CHWs agreed with the designed application prototype.  This finding shows that CHWs has an interest in using the mobile application in their work. Using the mobile application will help CHWs to improve data collection, the reporting process, and ease of receiving training.

scholarly journals Health Facility-based Counselling and Community Outreach are Associated with Maternal Dietary Practices in a Cross-sectional Study from Tanzania

2021 ◽  
Author(s):  
Kirk A. Dearden ◽  
Ramu Bishwakarma ◽  
Benjamin T. Crookston ◽  
Benesta T. Masau ◽  
Generose I. Mulokozi
Keyword(s):  
Health Services ◽  
Community Health ◽  
Health Worker ◽  
Health Facility ◽  
Community Health Worker ◽  
Children's Health ◽  
Dietary Behaviors ◽  
Access To Health Services ◽  
Dietary Practices ◽  
Access To Health

Abstract Background: Anemia and underweight among women are major public health challenges. Access to health services can improve dietary behaviors and women’s nutritional status. We examined whether exposure to health services is associated with women’s dietary practices in Tanzania.Methods: Data come from a two-stage, randomized baseline survey among 5,000 female primary caregivers prior to implementing a maternal and child nutrition program. We ran frequencies on women’s exposure to existing health facility-based counselling, community health worker visits, and attendance at women’s support groups. We examined associations between exposure to these interventions and maternal diets and adjusted for sociodemographic covariates using ordinary least squares regression and ordered logistic regression.Results: A third of the sample (34.1 percent) had received any antenatal care (ANC) during their most recent pregnancy or had been advised by anyone about nutrition (37.0 percent). 68.0 percent had never had a community health worker (CHW) speak to them about their children’s health and 9.4 percent had participated in a women’s group. Only 8.0 percent of mothers ate more than usual during pregnancy and 7.1 percent ate more types of foods. After adjusting for mother’s age, education and household assets, women who received nutrition advice were 1.3 times (95 percent CI: 1.1, 1.7) more likely than mothers who did not to eat more during pregnancy. Receiving ANC and advice on nutrition before, during, and after pregnancy and delivery were highly associated with the mother eating more types of foods. Hearing from a CHW about children’s health but not support group attendance was often associated with various dietary practices. Almost all measures of access to health services were significantly associated with mothers’ frequency of eating in the previous 24 hours. Receiving advice on nutrition during pregnancy and after giving birth and CHW contact were associated with mothers’ dietary diversity in the previous 24 hours. Conclusions: Several program exposure variables—especially being counselled about nutrition—were associated with improved dietary practices. Improving service delivery at scale may contribute to improved dietary behaviors in larger populations, given the associations we describe, along with findings from the existing literature.

scholarly journals Expanding the use of community health workers in urban settings: a potential strategy for progress towards universal health coverage

2019 ◽  
Author(s):  
Brian Wahl ◽  
Susanna Lehtimaki ◽  
Stefan Germann ◽  
Nina Schwalbe
Keyword(s):  
Health Services ◽  
Community Health ◽  
Low Income ◽  
Urban Areas ◽  
Access To Health Services ◽  
Middle Income ◽  
Urban Settings ◽  
Middle Income Countries ◽  
Access To Health ◽  
Low And Middle Income

Abstract Community health worker (CHW) programmes have been used for decades to improve access to health services in rural settings in low- and middle-income countries. With more than half of the world’s population currently living in urban areas and this population expected to grow, equitable access to health services in urban areas is critically important. To understand the extent to which CHW programmes have been successfully deployed in low-income urban settings, we conducted a review of the literature between 2000 and 2018 to identify studies evaluating and describing CHW programmes implemented fully or partially in urban or peri-urban settings. We identified 32 peer-reviewed articles that met our inclusion criteria. Benefits have been documented in several urban settings in low- and middle-income countries including those to address TB/HIV, child health, maternal health and non-communicable diseases through a variety of study designs.

scholarly journals An exploratory study of the barriers and facilitators to the implementation of community health worker programmes in conflict-affected South Sudan.

2021 ◽  
Author(s):  
George William Lutwama ◽  
Maryse Kok ◽  
Eelco Jacobs
Keyword(s):  
Community Health ◽  
Access To Health Care ◽  
Health Workers ◽  
South Sudan ◽  
Scale Up ◽  
Barriers And Facilitators ◽  
Drug Misuse ◽  
Access To Health Services ◽  
Access To Health ◽  
The Government

Abstract Background: Community health workers (CHWs) are crucial for increasing access to health services to communities. Due to decades of conflict and under-funding, access to health care in South Sudan remains severely limited. To improve equitable access to healthcare, the government has introduced “the Boma Health Initiative (BHI)”, a strategy to harmonise community health programmes across the country. In order to scale up the BHI, it is necessary to assess the recent CHW programmes and draw lessons for future implementation. This study aimed to explore the characteristics, barriers, and facilitators to the implementation of CHW interventions in South Sudan between 2011 and 2019.Methods: The study used a qualitative approach drawing from 26 key informant interviews and a scoping review of 21 Health Pooled Fund (HPF) programme reports from October 2016 to June 2018 and policy documents from 2011 to 2019. The results were thematically analysed based on a conceptual framework on factors influencing the performance of CHWs.Results: Funding of CHW programmes has come from international donors, channelled through non-governmental organisations (NGOs) that have implemented a variety of CHW programmes. Communities have been participating in the selection of voluntary CHWs, intervention areas, and occasionally in the supervision of activities performed by CHWs. The coordination mechanisms among stakeholders have been weak, leading to wastage and duplication of resources. Although training of CHWs is done, training duration was short, and refresher-trainings were rare. There were and still are disparities in the type of incentives provided to CHWs. Monitoring and supportive supervision activities have been insufficient; drug misuse and stock-outs were common. Conclusion: Despite their challenges, CHW programmes can be implemented in conflict-affected South Sudan if the local human capital is leveraged and engaged by NGOs as implementing partners. Robust coordination efforts are required to build synergies among stakeholders for the effective implementation of the BHI strategy.

Gambaran Epidemiologi Hipertensi di Puskesmas Gamping I

2017 ◽  
Vol 19 (1) ◽  
pp. 43-50
Author(s):  
Sekti Riyantina ◽  
Th Ninuk Sri Hartini ◽  
Idi Setiyobroto
Keyword(s):  
Population Density ◽  
Health Services ◽  
Community Health ◽  
Health Center ◽  
Access To Health Care ◽  
Community Health Center ◽  
Communicable Diseases ◽  
Access To Health Services ◽  
Access To Health ◽  
Gender Education

Background : Epidemiological transition stems from a change where a decline in the prevalence of communicable diseases and non- communicable diseases (NCDs) have increased. Report in 2011 there was one billion people worldwide suffer from hypertension and in Indonesia the figure reached 31.7%. Objective : The purpose of this study was to determine the epidemiological of hypertension Gamping I Community Health Center and determine the proportion of hypertension according to age, sex, occupation, education, socio-economic, geographic, demographic and access to health services. Method : The research design was a retrospective cohort. This research was conducted in Gamping I Community Health Center in November 2016. Population and sample in this study were all patients with hypertension in Gamping I Community Health Center in 2013, 2014 and 2015. The independent variables in this study were age, gender, education, employment, social, cultural, demographic population density, geographic and ease of access to health services. While the dependent variable is the proportion of hypertension. Data analysis was performed using Chi Square to know know the proportions of age, gender, education, employment, social, economic, population density, geography, access to health services with hypertension in 2013, 2014 and 2015. Result : Based on the analysis proves the young elderly, women, housewife, secondary education, non-poor families, low-lying area, population density and access to health care were likely to have hypertension with percentages respectively 33%, 66.7%, 44.9%, 70.1%, 76.7% , 71.9%, 37.9% and 82.9%.   Keywords: Hypertension, Epidemiology

scholarly journals Promoting Hispanic Immigrant Health via Community Health Workers and Motivational Interviewing

2020 ◽  
Vol 41 (1) ◽  
pp. 3-6
Author(s):  
Erin M. Portillo ◽  
Denise Vasquez ◽  
Louis D. Brown
Keyword(s):  
Health Services ◽  
Motivational Interviewing ◽  
Community Health ◽  
Community Health Workers ◽  
Immigrant Health ◽  
Health Workers ◽  
Health Resources ◽  
Health Promotion Program ◽  
Public Health Department ◽  
Access To Health Services

Hispanic immigrant health disparities are among the highest in the nation, especially related to obesity and access to health services. Healthy Fit (En Forma Saludable) is a health promotion program that leverages public health department infrastructure to address these disparities through the use of three key innovations explored in this article: community health workers (CHWs), motivational interviewing (MI), and vouchers for free preventative health services. CHWs trained in MI conduct a health screening and then distribute preventive service vouchers and health resources as needed based on screening results. Vouchers cover breast, cervical, and colorectal cancer screening, and several vaccinations including flu and human papillomavirus. Resources to support exercise, to support a healthy diet, to quit smoking, and to reduce risky drinking are also distributed as needed. CHWs then use MI to address perceived barriers and strengthen intrinsic motivation to make use of the health resources. Integrating these strategies provides a low-cost approach to promote healthy behavior in an underserved immigrant population.

scholarly journals Health facility-based counselling and community outreach are associated with maternal dietary practices in a cross-sectional study from Tanzania

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kirk A. Dearden ◽  
Ramu Bishwakarma ◽  
Benjamin T. Crookston ◽  
Benesta T. Masau ◽  
Generose I. Mulokozi
Keyword(s):  
Health Services ◽  
Antenatal Care ◽  
Community Health ◽  
Health Worker ◽  
Health Facility ◽  
Dietary Behaviors ◽  
Access To Health Services ◽  
Dietary Practices ◽  
Cross Sectional ◽  
Access To Health

Abstract Background Anemia and underweight among women are major public health challenges. Access to health services can improve dietary behaviors and women’s nutritional status. We examined whether exposure to health services is associated with women’s dietary practices in Tanzania. Methods Data come from a cross-sectional baseline survey among 5000 female primary caregivers who were randomly selected via two-stage sampling, prior to implementing a maternal and child nutrition program. We ran frequencies on women’s exposure to existing health facility-based counselling, community health worker visits, and attendance at women’s support groups. We examined associations between exposure to these interventions and maternal diets and adjusted for sociodemographic covariates using ordinary least squares regression and ordered logistic regression. Results A third of the sample (34.1%) had received any antenatal care (ANC) during their most recent pregnancy or had been advised by anyone about nutrition (37.0%). 68.0% had never had a community health worker (CHW) speak to them about their children’s health and 9.4% had participated in a women’s group. Only 8.0% of mothers ate more than usual during pregnancy and 7.1% ate more types of foods. After adjusting for mother’s age, education and household assets, women who received nutrition advice were 1.3 times (95% CI: 1.1, 1.7) more likely than mothers who did not to eat more during pregnancy. Receiving antenatal care (ANC) and advice on nutrition before, during, and after pregnancy and delivery were highly associated with the mother eating more types of foods. Hearing from a CHW about children’s health but not support group attendance was often associated with various dietary practices. Almost all measures of access to health services were significantly associated with mothers’ frequency of eating in the previous 24 h. Receiving advice on nutrition during pregnancy and after giving birth and CHW contact were associated with mothers’ dietary diversity in the previous 24 h. Conclusions Several program exposure variables—especially being counselled about nutrition—were associated with improved dietary practices. Improving service delivery at scale may contribute to improved dietary behaviors in larger populations, given the associations we describe, along with findings from the existing literature.

scholarly journals Community health workers: challenges and vulnerabilities of Accredited Social Health Activists working in conflict-affected settings in the state of Assam, India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Preety R Rajbangshi ◽  
Devaki Nambiar ◽  
Aradhana Srivastava
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Social Relations ◽  
Health Workers ◽  
Social Health ◽  
Access To Health Services ◽  
North East ◽  
The North ◽  
East Region ◽  
Access To Health

Abstract Introduction It is well acknowledged that India’s community health workers known as Accredited Social Health Activists (ASHA) are the bedrock of its health system. Many ASHAs are currently working in fragile and conflict-affected settings. No efforts have yet been made to understand the challenges and vulnerabilities of these female workers. This paper seeks to address this gap by bringing attention to the situation of ASHAs working in the fragile and conflict settings and how conflict impacts them and their work. Methods Qualitative fieldwork was undertaken in four conflict-affected villages in two conflict-affected districts -Kokrajhar and Karbi Anglong of Assam state situated in the North-East region of India. Detailed account of four ASHAs serving roughly 4000 people is presented. Data transliterated into English were analysed by authors by developing a codebook using grounded theory and thematic organisation of codes. Results ASHAs reported facing challenges in ensuring access to health services during and immediately after outbreaks of conflict. They experienced difficulty in arranging transport and breakdown of services at remote health facilities. Their physical safety and security were at risk during episodes of conflict. ASHAs reported hostile attitudes of the communities they served due to the breakdown of social relations, trauma due to displacement, and loss of family members, particularly their husbands. Conclusions Conflict must be recognised as an important context within which community health workers operate, with greater policy focus and research devoted to understanding and addressing the barriers they face as workers and as persons affected by conflict.

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