scholarly journals The Effectiveness of Health Services Delivered by Community Health Workers on Outcomes Related to Non-Communicable Diseases among Elderly People in Rural Areas: A Systematic Review

Author(s):  
Vita Widyasari ◽  
Ferry Fadzlul Rahman ◽  
Kuan-Han Lin ◽  
Jiun-Yi Wang

Background: The number of elderly and the burden of non-communicable diseases increase with time. Community involvement is expected to be an important prevention agent for their neighbors. This study aimed to determine the effectiveness of health services delivered by community health workers (CHWs) which focus on physiological indices related to non-communicable diseases among elderly people and to explain the health services or interventions carried out by CHWs.   Methods: This systematic review was conducted based on the PRISMA guidelines. PubMed, ProQuest Science Database, Scopus, EBSCOhost CINAHL, and Web of Science were taken as the source of databases. Manual search was also conducted for articles published before March 2019 without time restriction. The quality of each study was assessed using Critical Checklist by Joanna Briggs Institute. Results: Of the 3,275 initial studies retrieved, 4 studies were included in qualitative synthesis analysis. Three studies arranged a face-to-face interview, while the other study was conducted over the phone. All the 4 studies were intervention studies. Three of them showed a significant improvement in mean systolic blood pressure for the intervention group compared to the control group. The other study showed a significant improvement in weight loss for the intervention group. Conclusion: Health services delivered by CHWs was beneficial to elderly people in rural areas on some physiological indices. It suggested that health services delivered CHWs could contribute toward secondary prevention programs.

2021 ◽  
Vol 9 (1) ◽  
pp. 13-32
Author(s):  
Rizkiyani Istifada ◽  
Etty Rekawati ◽  
Wiwin Wiarsih

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.


Author(s):  
Mamta Nebhinani ◽  
Sushma K. Saini

Background: The increasing burden of Non communicable diseases calls for added role on the part of health professionals. The female Health workers being the closest to population play an important role in alleviating the problem to great extent. Objective of this study was to assess the Knowledge, and skills of female health workers (FHWs) regarding selected non communicable diseases risk reduction and the client satisfaction with NCD skill services performed by FHWs.Methods: This study was undertaken at selected health centres of Jodhpur. FHWs working at these centres and women receiving health services from FHWs were recruited for the study. Data were collected using predesigned NCD knowledge questionnaire, skill checklist and client satisfaction scale. Method of data collection were paper pencil questionnaire, observation and interview. Descriptive and inferential statistics were calculated to summarize demographics and key variables.Results: Nearly 24% and 35% of FHWs had average knowledge regarding HTN/ diabetes, breast and cervical cancer respectively. 47% of subjects had good level of knowledge regarding mental health. Most of FHWs (77%) had adequate BP measurement and RBS testing skills. Majority had inadequate breast examination and waist circumference measurement skills. Level of knowledge related to hypertension and diabetes were found to be significantly associated with NCD training of health workers in past (p level=0.03). Nearly 67% of the women were satisfied with the NCD health services provided by FHWs.Conclusions: Overall FHWs had average level of awareness regarding different NCDs’ prevention and control. Routine skills pertaining to NCDs screening methods such as BP and blood glucose measurement were adequate among FHWs. Overall women were satisfied with the NCD related health services provided by FHWs. Being an important concern there is need to plan refresher training programs for these health workers so that their services can be effectively utilized for prevention and control of NCDs.


2020 ◽  
Author(s):  
Lal Rawal ◽  
Shamim Jubayer ◽  
Shohel R Choudhury ◽  
Sheikh Mohammad Shariful Islam ◽  
Abu Abdullah

Abstract Objective: To examine the barriers and facilitators to engaging Community Health Workers (CHWs) for Non-communicable Diseases (NCDs) prevention and control in Bangladesh.Design: We used multipronged approaches, including a. Situation analyses using a literature review, key personnel and stakeholders’ meetings, and exploratory studies. A grounded theory approach was used for qualitative data collection, and data were analysed thematically.Setting: Data were collected from health facilities across three districts in Bangladesh, and two stakeholder consultative meetings were conducted at the central level.Participants: We conducted in-depth interviews with CHWs (Health Inspector; Community Health Care Provider; Health Assistant and Health Supervisor) (n=4); key informant interviews with central level health policymakers/ managers (n=15) and focus group discussions with CHWs (4 FGDs; total n=29). Participants in a stakeholder consultative meeting included members from the government (n=4), non-government organisations (n=2), private sector (n=1) and universities (n=2).Results: The CHWs in Bangladesh deliver a wide range of public health programs. They also provide several NCDs specific services, including screening, provisional diagnosis, and health education and counselling for common NCDs, dispatching of basic medications, and referral to relevant health facilities. These services are being delivered from the sub-district health facility, community clinics and urban health clinics. The participants identified key challenges and barriers, which include lack of NCD specific guidelines, inadequate training, excessive workload, inadequate systems-level support, and lack of logistics supplies and drugs. The facilitating factors to engage CHWs included government commitment and program priority, development of NCD related policies and strategies, the establishment of NCD corners, community support systems, social recognition and staff motivation.Conclusion: Engaging CHWs has been a key driver to NCDs services delivery in Bangladesh. However, there is a need for capacity building of CHWs, systems-level support and maximizing CHWs engagement to prevention and control of NCDs in Bangladesh.


2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Lal Rawal ◽  
Shamim Jubayer ◽  
Sohel R. Choudhury ◽  
Sheikh Mohammed Shariful Islam ◽  
Abu S. Abdullah

Abstract Background The increasing burden of Non-Communicable Diseases (NCDs) in Bangladesh underscores the importance of strengthening primary health care systems. In this study, we examined the barriers and facilitators to engaging Community Health Workers (CHWs) for NCDs prevention and control in Bangladesh. Methods We used multipronged approaches, including a. Situation analyses using a literature review, key personnel and stakeholders’ consultative meetings, and exploratory studies. A grounded theory approach was used for qualitative data collection from health facilities across three districts in Bangladesh. We conducted in-depth interviews with CHWs (Health Inspector; Community Health Care Provider; Health Assistant and Health Supervisor) (n = 4); key informant interviews with central level health policymakers/ managers (n = 15) and focus group discussions with CHWs (4 FGDs; total n = 29). Participants in a stakeholder consultative meeting included members from the government (n = 4), non-government organisations (n = 2), private sector (n = 1) and universities (n = 2). Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data analyses. Results The CHWs in Bangladesh deliver a wide range of public health programs. They also provide several NCDs specific services, including screening, provisional diagnosis, and health education and counselling for common NCDs, dispensing basic medications, and referral to relevant health facilities. These services are being delivered from the sub-district health facility, community clinics and urban health clinics. The participants identified key challenges and barriers, which include lack of NCD specific guidelines, inadequate training, excessive workload, inadequate systems-level support, and lack of logistics supplies and drugs. Yet, the facilitating factors to engaging CHWs included government commitment and program priority, development of NCD related policies and strategies, establishment of NCD corners, community support systems, social recognition of health care staff and their motivation. Conclusion Engaging CHWs has been a key driver to NCDs services delivery in Bangladesh. However, there is a need for building capacity of CHWs, maximizing CHWs engagement to NCD services delivery, facilitating systems-level support and strengthening partnerships with non-state sectors would be effective in prevention and control efforts of NCDs in Bangladesh.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
David Musoke ◽  
Edwinah Atusingwize ◽  
Deborah Ikhile ◽  
Sarah Nalinya ◽  
Charles Ssemugabo ◽  
...  

Abstract Background Community health workers (CHWs) are an important cadre of the global health workforce as they are involved in providing health services at the community level. However, evidence on the role of CHWs in delivering interventions for non-communicable diseases (NCDs) in Uganda is limited. This study, therefore, assessed the involvement of CHWs in the prevention and control of NCDs in Wakiso District, Uganda with a focus on their knowledge, attitudes and practices, as well as community perceptions. Methods A cross-sectional study using mixed methods was conducted which involved a structured questionnaire among 485 CHWs, and 6 focus group discussions (FGDs) among community members. The study assessed knowledge, perceptions including the importance of the various risk factors, and the current involvement of CHWs in NCDs, including the challenges they faced. Quantitative data were analysed in STATA version 13.0 while thematic analysis was used for the qualitative data. Results The majority of CHWs (75.3%) correctly defined what NCDs are. Among CHWs who knew examples of NCDs (87.4%), the majority mentioned high blood pressure (77.1%), diabetes (73.4%) and cancer (63.0%). Many CHWs said that healthy diet (86.2%), physical activity (77.7%), avoiding smoking/tobacco use (70.9%), and limiting alcohol consumption (63.7%) were very important to prevent NCDs. Although more than half of the CHWs (63.1%) reported being involved in NCDs activities, only 20.9 and 20.6% had participated in community mobilisation and referral of patients respectively. The majority of CHWs (80.1%) who were involved in NCDs prevention and control reported challenges including inadequate knowledge (58.4%), lack of training (37.6%), and negative community perception towards NCDs (35.1%). From the FGDs, community members were concerned that CHWs did not have enough training on NCDs hence lacked enough information. Therefore, the community did not have much confidence in them regarding NCDs, hence rarely consulted them concerning these diseases. Conclusions Despite CHWs having some knowledge on NCDs and their risk factors, their involvement in the prevention and control of the diseases was low. Through enhanced training and community engagement, CHWs can contribute to the prevention and control of NCDs, including health education and community mobilisation.


2020 ◽  
Vol 13 (1) ◽  
pp. 430-437
Author(s):  
Sunday O. Onagbiye ◽  
Lungiswa P. Tsolekile ◽  
Thandi Puoane

Introduction: Community Health Workers play an important role in supporting patients with chronic non-communicable diseases (NCDs), therefore they need to be constantly updated with current knowledge to enable them to perform their activities effectively. The purpose of this study was to assess the knowledge of NCDs risk factors among Community Health Workers (CHWs) in South Africa. Methodology: A triple “A” approach (assessment, analysis, and action) was used among 40 CHWs working with patients with chronic non-communicable diseases. All CHWs gave voluntary, informed consent in writing and verbally before they were allowed to participate in the study. For the initial assessment, CHWs completed a questionnaire to assess knowledge about the knowledge of NCDs. The questionnaire was analysed to determine their baseline performance. The findings of the assessment identified shortcomings in the knowledge of CHWs, specifically on diabetes and hypertension knowledge. Feedback was given to the CHWs followed by a short training on healthy living, focusing on the risk factors associated with NCDs (diabetes and hypertension). Training of CHWs was conducted using an adapted national training programme together with CHW prevention of healthy lifestyle modules designed by experts from the School of Public Health, University of the Western Cape. All statistical tests were two-tailed, and p<.05 was considered statistically significant. Results: The majority (97.5%) of the CHWs who had their knowledge assessed were women. Fifty-five percent (55%) were within age 30-45 years, while 45% were between the ages 46-60 years. The majority of the participants had secondary school education (92.5%) and 1-15 years of experience (97.5%) as CHWs. The results of the post-training assessment revealed that 48.5%, 63.6%, 42.4%, 72.7%, 42.5%, 57.6%, and 18.2% had poor knowledge of diabetes, hypertension, diabetes complications, hypertension complications, advice for diabetic patient, advice for hypertension, and nutrition advice of NCDs, respectively. Regression analysis showed that those with higher education levels were significantly highly likely to be knowledgeable about hypertension complications (OR=19.6, CI=1.14, 336.0). Conclusion: There was poor knowledge of risk factors for NCDs among CHWs. An association exists between the knowledge of risk factors for NCDs and education levels among the participants. There is a need for regular refresher training programs for CHWs to upscale their knowledge about NCDs, coupled with frequent review of CHWs program and curriculum.


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