scholarly journals A Feasibility Study to Assess Non-clinical Community Health Workers’ Capacity to use Simplified Protocols and Tools to Treat Severe Acute Malnutrition in Niger State Nigeria

2021 ◽  
Author(s):  
Olatunde Adesoro ◽  
Olusola Oresanya ◽  
Helen Counihan ◽  
Prudence Hamade ◽  
Dare Eguavon ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Severe Acute Malnutrition ◽  
Full Recovery ◽  
Childhood Mortality ◽  
Acute Malnutrition ◽  
Community Case Management ◽  
Integrated Community Case Management ◽  
Clinical Community

Abstract Background: Severe acute malnutrition (SAM) is a major determinant of childhood mortality and morbidity. Although integrated community case management (iCCM) of childhood illnesses is a strategy for increasing access to life-saving treatment, malnutrition is not properly addressed in the guidelines. This study aimed to determine whether non-clinical Community Health Workers (called Community-Oriented Resource Persons, CORPs) implementing iCCM could use simplified tools to treat uncomplicated SAM.Methods: The study used a sequential mixed-method design and was conducted between July 2017 and May 2018. Sixty CORPs already providing iCCM services were trained and deployed in their communities with the target of enrolling 290 SAM cases. Competency of CORPs to treat and the treatment outcomes of enrolled children were documented. SAM cases with MUAC of 9cm to < 11.5cm without medical complications were treated for up to 12 weeks. Full recovery was at MUAC≥12.5cm for two consecutive weeks. Supervision and quantitative data capturing were done weekly while qualitative data were collected after the intervention.Results: CORPs scored 93.1% on first assessment and increment of 0.11 (95% CI: 0.05 – 0.18) points per additional supervision conducted. The cure rate from SAM to full recovery, excluding referrals from the denominator in line with the standard for reporting SAM recovery rates, was 73.5% and the median length of treatment was seven weeks. SAM cases enrolled at 9cm to <10.25cm MUAC had 29% less likelihood of recovery compared to those enrolled at 10.25cm to <11.5cm. CORPs were not burdened by the integration of SAM into iCCM and felt motivated by children’s recovery. Operational challenges like bad terrains for supervision, supply chain management and referrals were reported by supervisors, while Government funding was identified as key for sustainability.Conclusion: The study demonstrated that with training and supportive supervision, CORPs in Nigeria can treat SAM among under-fives, and refer complicated cases using simplified protocols as part of an iCCM programme. This approach seemed acceptable to all stakeholders, however, the effect of the extra workload of integrating SAM into iCCM on the quality of care provided by the CORPs should be assessed further.

scholarly journals A feasibility study to assess non-clinical community health workers’ capacity to use simplified protocols and tools to treat severe acute malnutrition in Niger state Nigeria

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Olatunde Adesoro ◽  
Olusola Oresanya ◽  
Helen Counihan ◽  
Prudence Hamade ◽  
Dare Eguavon ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Severe Acute Malnutrition ◽  
Full Recovery ◽  
Childhood Mortality ◽  
Acute Malnutrition ◽  
Community Case Management ◽  
Integrated Community Case Management ◽  
Clinical Community

Abstract Background Severe acute malnutrition (SAM) is a major determinant of childhood mortality and morbidity. Although integrated community case management (iCCM) of childhood illnesses is a strategy for increasing access to life-saving treatment, malnutrition is not properly addressed in the guidelines. This study aimed to determine whether non-clinical Community Health Workers (called Community-Oriented Resource Persons, CORPs) implementing iCCM could use simplified tools to treat uncomplicated SAM. Methods The study used a sequential multi-method design and was conducted between July 2017 and May 2018. Sixty CORPs already providing iCCM services were trained and deployed in their communities with the target of enrolling 290 SAM cases. Competency of CORPs to treat and the treatment outcomes of enrolled children were documented. SAM cases with MUAC of 9 cm to < 11.5 cm without medical complications were treated for up to 12 weeks. Full recovery was at MUAC≥12.5 cm for two consecutive weeks. Supervision and quantitative data capturing were done weekly while qualitative data were collected after the intervention. Results CORPs scored 93.1% on first assessment and increment of 0.11 (95% CI, 0.05–0.18) points per additional supervision conducted. The cure rate from SAM to full recovery, excluding referrals from the denominator in line with the standard for reporting SAM recovery rates, was 73.5% and the median length of treatment was 7 weeks. SAM cases enrolled at 9 cm to < 10.25 cm MUAC had 31% less likelihood of recovery compared to those enrolled at 10.25 cm to < 11.5 cm. CORPs were not burdened by the integration of SAM into iCCM and felt motivated by children’s recovery. Operational challenges like bad terrains for supervision, supply chain management and referrals were reported by supervisors, while Government funding was identified as key for sustainability. Conclusion The study demonstrated that with training and supportive supervision, CORPs in Nigeria can treat SAM among under-fives, and refer complicated cases using simplified protocols as part of an iCCM programme. This approach seemed acceptable to all stakeholders, however, the effect of the extra workload of integrating SAM into iCCM on the quality of care provided by the CORPs should be assessed further.

scholarly journals Cost-effectiveness of the community-based management of severe acute malnutrition by community health workers in southern Bangladesh

2012 ◽  
Vol 28 (4) ◽  
pp. 386-399 ◽  
Author(s):  
Chloe Puett ◽  
Kate Sadler ◽  
Harold Alderman ◽  
Jennifer Coates ◽  
John L. Fiedler ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Community Based

scholarly journals Contribution of Community Health Workers to the treatment of common illnesses among under 5-year-olds in rural Uganda.

2021 ◽  
Author(s):  
Fred Bagenda ◽  
Andrew Christopher Wesuta ◽  
Geren Stone ◽  
Moses Ntaro ◽  
Palka Patel ◽  
...  
Keyword(s):  
Case Management ◽  
Community Health ◽  
Community Health Workers ◽  
Management Strategy ◽  
Health Workers ◽  
Community Case Management ◽  
Integrated Community Case Management ◽  
Children Under Five ◽  
Under Five ◽  
Common Illnesses

Abstract Introduction The control of malaria, pneumonia, and diarrhea is important for the reduction in morbidity and mortality among children under five years. Uganda has adopted the Integrated Community Case Management strategy using Community Health Workers to address this challenge. The extent and trend of these three conditions managed by the Community Health Workers are not well documented. This study was done to document Community Health Workers’ contribution towards treatment and the trends of the three common illnesses in Bugoye Sub-County in rural Uganda.

scholarly journals Toward a geography of community health workers in Niger: a geospatial analysis

2021 ◽  
Author(s):  
Nicholas P Oliphant ◽  
Nicolas Ray ◽  
Khaled Bensaid ◽  
Adama Ouedraogo ◽  
Asma Yaroh Gali ◽  
...  
Keyword(s):  
High Resolution ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Health Facilities ◽  
Health Coverage ◽  
Community Case Management ◽  
Front Line ◽  
Integrated Community Case Management ◽  
Geographical Accessibility

Background Little is known about the geography of community health workers (CHWs), their contribution to geographical accessibility of primary health care (PHC) services, and strategies for optimizing efficiency of CHW deployment in the context of universal health coverage (UHC). Methods Using a complete georeferenced census of front-line health facilities and CHWs in Niger and other high resolution spatial datasets, we modelled travel times to front-line health facilities and CHWs between 2000-2013, accounting for training, essential commodities, and maximum population capacity. We estimated additional CHWs needed to maximize geographical accessibility of the population beyond the reach of existing front-line health facilities and CHWs. We assessed the efficiency of geographical targeting of the existing CHW network compared to modelled CHW networks designed to optimize geographical targeting of the estimated population, under-five deaths, and plasmodium falciparum malaria cases. Results The percent of the population within 60 minutes walking to the nearest CHW increased from 0·0% to 17·5% between 2000-2013, with 15·5% within 60 minutes walking to the nearest CHW trained on integrated community case management (iCCM) — making PHC services and iCCM, specifically, geographically accessible for an estimated 2·3 million and 2·0 million additional people, respectively. An estimated 10·4 million people (59·0%) remained beyond a 60-minute catchment of front-line health facilities and CHWs. Optimal deployment of 8064 additional CHWs could increase geographic coverage of the estimated total population from 41·5% to 73·6%. Geographical targeting of the existing CHW network was inefficient but optimized CHW networks could improve efficiency by 55·0%-81·9%, depending on targeting metric. Interpretations We provide the first high-resolution maps and estimates of geographical accessibility to CHWs at national scale, highlighting improvements between 2000-2013 in Niger, geographies where gaps remained, approaches for improving targeting, and the importance of putting CHWs on the map to inform planning in the context of UHC.

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