scholarly journals Effect of a community-based intervention for cardiovascular risk factor control on stroke mortality in rural Gadchiroli, India: study protocol for a cluster randomised controlled trial

2019 ◽  
Author(s):  
Yogeshwar Kalkonde ◽  
Mahesh Deshmukh ◽  
Sindhu Nila ◽  
Sunil Jadhao ◽  
Abhay Bang
Keyword(s):  
Prevention And Control ◽  
Preventive Intervention ◽  
Health Workers ◽  
Controlled Trial ◽  
Communicable Diseases ◽  
Stroke Mortality ◽  
Intervention Package ◽  
Community Based ◽  
Non Communicable Diseases ◽  
And Control

Abstract Background Stroke has emerged as a leading cause of death in rural India. However, well tested healthcare interventions to reduce stroke mortality in rural under-resourced settings are lacking. The aim of this study is to evaluate the effect of a community-based preventive intervention on stroke mortality in rural Gadchiroli, India. Methods The study is a two-arm, parallel group, cluster randimised controlled trial where 32 villages each will be randomised to the intervention and the enhanced usual care (EUC) arm. In the intervention arm, individuals ≥ 50 years of age will be screened for hypertension, diabetes and stroke by trained Community Health Workers (CHWs). Screen positive individuals will be referred to a mobile outreach clinic which will visit intervention villages. A physician in the clinic will confirm the diagnosis, provide guideline-based treatment and follow up patients at periodic intervals. The CHWs will make home visits once a month to ensure medication compliance and counsel patients to reduce salt consumption and quit tobacco and alcohol. In the EUC arm, households will be provided information on the ill effects of tobacco and steps to quit it. Individuals from both the arms will have access to government’s national programme for prevention and control of non-communicable diseases where treatment for hypertension, diabetes and stroke is available at the primary health centres (PHCs). The intervention will be implemented for 3.5 years. The primary outcome will be reduction in stroke mortality in the last 2.5 years of the intervention. Discussion This trial will provide important information regarding the feasibility and effect of a community-based preventive intervention package on stroke mortality in a rural under-resourced setting and can inform India’s non-communicable diseases prevention and control programme. If successful, such an intervention can be scaled up in rural regions of India and other countries.

scholarly journals Effect of a community-based intervention for cardiovascular risk factor control on stroke mortality in rural Gadchiroli, India: study protocol for a cluster randomised controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yogeshwar Kalkonde ◽  
Mahesh Deshmukh ◽  
Sindhu Nila ◽  
Sunil Jadhao ◽  
Abhay Bang
Keyword(s):  
Randomised Controlled Trial ◽  
Prevention And Control ◽  
Preventive Intervention ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Stroke Mortality ◽  
Community Based ◽  
Cluster Randomised ◽  
Randomised Controlled ◽  
And Control

Abstract Background Stroke has emerged as a leading cause of death in rural India. However, well-tested healthcare interventions to reduce stroke mortality in rural under-resourced settings are lacking. The aim of this study is to evaluate the effect of a community-based preventive intervention on stroke mortality in rural Gadchiroli, India. Methods The study is a two-arm, parallel group, cluster randomised controlled trial in which 32 villages will be randomised to the intervention and the enhanced usual care (EUC) arm. In the intervention arm, individuals ≥50 years of age will be screened for hypertension, diabetes and stroke by trained Community Health Workers (CHWs). Screened individuals who are positive will be referred to a mobile outreach clinic which will visit the intervention villages periodically. A physician in the clinic will confirm the diagnosis, provide guideline-based treatment and follow up patients. The CHWs will make home visits once a month to ensure medication compliance and counsel patients to reduce salt consumption and quit tobacco and alcohol. In the EUC arm, households will be provided information on the ill effects of tobacco use and steps to quit it. Individuals from both the arms will have access to the government’s national programme for the prevention and control of non-communicable diseases, where treatment for hypertension, diabetes and preventive treatment after stroke is available at the nearest primary health centres (PHCs). The intervention will be implemented for 3.5 years. The primary outcome will be a reduction in stroke mortality in the last 2.5 years of the intervention. Discussion This trial will provide important information regarding the feasibility and effect of a community-based preventive intervention package on stroke mortality in a rural under-resourced setting and can inform India’s non-communicable diseases prevention and control programme. If successful, such an intervention can be scaled up in the rural regions of India and other countries. Trial registration Clinical Trials Registry of India: CTRI/2015/12/006424. Registered on 8 December 2015.

scholarly journals Effect of a community-based intervention for cardiovascular risk factor control on stroke mortality in rural Gadchiroli, India: study protocol for a cluster randomised controlled trial

2019 ◽  
Author(s):  
Yogeshwar Kalkonde ◽  
Mahesh Deshmukh ◽  
Sindhu Nila ◽  
Sunil Jadhao ◽  
Abhay Bang
Keyword(s):  
Randomised Controlled Trial ◽  
Prevention And Control ◽  
Preventive Intervention ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Stroke Mortality ◽  
Community Based ◽  
Cluster Randomised ◽  
Randomised Controlled ◽  
And Control

Abstract Background Stroke has emerged as a leading cause of death in rural India. However, well tested healthcare interventions to reduce stroke mortality in rural under-resourced settings are lacking. The aim of this study is to evaluate the effect of a community-based preventive intervention on stroke mortality in rural Gadchiroli, India. Methods The study is a two-arm, parallel group, cluster randomised controlled trial where 32 villages each will be randomised to the intervention and the enhanced usual care (EUC) arm. In the intervention arm, individuals ≥ 50 years of age will be screened for hypertension, diabetes and stroke by trained Community Health Workers (CHWs). Screen positive individuals will be referred to a mobile outreach clinic which will visit intervention villages. A physician in the clinic will confirm the diagnosis, provide guideline-based treatment and follow up patients at periodic intervals. The CHWs will make home visits once a month to ensure medication compliance and counsel patients to reduce salt consumption and quit tobacco and alcohol. In the EUC arm, households will be provided information on the ill effects of tobacco and steps to quit it. Individuals from both the arms will have access to government’s national programme for prevention and control of non-communicable diseases where treatment for hypertension, diabetes and preventive treatment after stroke is available, nearest at the primary health centres (PHCs). The intervention will be implemented for 3.5 years. The primary outcome will be reduction in stroke mortality in the last 2.5 years of the intervention. Discussion This trial will provide important information regarding the feasibility and effect of a community-based preventive intervention package on stroke mortality in a rural under-resourced setting and can inform India’s non-communicable diseases prevention and control programme. If successful, such an intervention can be scaled up in rural regions of India and other countries.

scholarly journals Knowledge, skills of female health workers regarding selected non communicable diseases risk reduction and client satisfaction: a pilot study from western part of Rajasthan, India

2020 ◽  
Vol 8 (8) ◽  
pp. 2802
Author(s):  
Mamta Nebhinani ◽  
Sushma K. Saini
Keyword(s):  
Health Services ◽  
Risk Reduction ◽  
Prevention And Control ◽  
Client Satisfaction ◽  
Health Workers ◽  
Communicable Diseases ◽  
Screening Methods ◽  
Non Communicable Diseases ◽  
Level Of Knowledge ◽  
And Control

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.

scholarly journals Community Health Workers for Non-Communicable Diseases Prevention and Control in Bangladesh: A Qualitative Study

2020 ◽  
Author(s):  
Lal Rawal ◽  
Shamim Jubayer ◽  
Shohel R Choudhury ◽  
Sheikh Mohammad Shariful Islam ◽  
Abu Abdullah
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Prevention And Control ◽  
Health Workers ◽  
Community Support ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Non Communicable Diseases ◽  
And Control ◽  
Central Level

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.

scholarly journals Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Lal Rawal ◽  
Shamim Jubayer ◽  
Sohel R. Choudhury ◽  
Sheikh Mohammed Shariful Islam ◽  
Abu S. Abdullah
Keyword(s):  
Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Prevention And Control ◽  
Qualitative Data ◽  
Health Workers ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
Services Delivery ◽  
And Control

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.

scholarly journals Community health workers’ involvement in the prevention and control of non-communicable diseases in Wakiso District, Uganda

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
David Musoke ◽  
Edwinah Atusingwize ◽  
Deborah Ikhile ◽  
Sarah Nalinya ◽  
Charles Ssemugabo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Community Health ◽  
Community Health Workers ◽  
Prevention And Control ◽  
Health Workers ◽  
Communicable Diseases ◽  
Community Mobilisation ◽  
Community Members ◽  
Non Communicable Diseases ◽  
And Control

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.

scholarly journals Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study

2020 ◽  
Author(s):  
Lal Rawal ◽  
Shamim Jubayer ◽  
Shohel R Choudhury ◽  
Sheikh Mohammad Shariful Islam ◽  
Abu Abdullah
Keyword(s):  
Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Prevention And Control ◽  
Qualitative Data ◽  
Health Workers ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
Services Delivery ◽  
And Control

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.

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