scholarly journals Feasibility of a Palliative Care Intervention Utilizing Community Health Workers to Facilitate Delivery of Home-based Palliative Care in India

2022 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
Kathleen B. Cartmell ◽  
Sarah Ann E. Kenneson ◽  
Rakesh Roy ◽  
Gautam Bhattacharjee ◽  
Nibedita Panda ◽  
...  
Keyword(s):  
Palliative Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Cancer Center ◽  
Intestinal Bleeding ◽  
Care Plans ◽  
Pain Scores ◽  
Home Based ◽  
Intervention Protocol

Objectives: The purpose of this study was to evaluate the feasibility of a home-based palliative care program delivered by community health workers (CHW) in rural areas outside of Kolkata, India. The specific aims were to assess CHWs’ ability to implement the intervention protocol and maintain records of care, to characterize patient problems and CHW activities to assist patients, and to assess change in patient pain scores over the course of the intervention. Materials and Methods: Four CHWs were hired to facilitate delivery of home-based palliative care services. CHWs were trained using the Worldwide Hospice and Palliative Care Alliance’s Palliative Care Toolkit. CHWs provided care for patients for 3-months, making regular home visits to monitor health, making and implementing care plans, and referring patients back to the cancer center team for serious problems. Results: Eleven patients enrolled in the intervention, with ten of these patients participating in the intervention and one patient passing away before starting the intervention. All ten participants reported physical pain, for which CHWs commonly recommended additional or higher dose medication and/or instructed patients how to take medication properly. For two patients, pain levels decreased between baseline and end of study, while pain scores did not decrease for the remaining patients. Other symptoms for which CHWs provided care included gastro-intestinal, bleeding, and respiratory problems. Conclusion: The study findings suggest that utilization of CHWs to provide palliative care in low-resource settings may be a feasible approach for expanding access to palliative care. CHWs were able to carry out the study visit protocol and assess and document patient problems and their activities to assist. They were also able to alleviate many common problems patients experienced with simple suggestions or referrals. However, most patients did not see a decrease in pain levels and more emphasis was needed on the emotional aspects of palliative care, and so CHWs may require additional training on provision of pain management and emotional support services.

scholarly journals Effectiveness of Home-Based Management of Newborn Infections by Community Health Workers in Rural Bangladesh

2009 ◽  
Vol 28 (4) ◽  
pp. 304-310 ◽  
Author(s):  
Abdullah H. Baqui ◽  
Shams E. Arifeen ◽  
Emma K. Williams ◽  
Saifuddin Ahmed ◽  
Ishtiaq Mannan ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Rural Bangladesh ◽  
Home Based

scholarly journals Integrating a nationally scaled workforce of community health workers in primary care: a modelling study

2018 ◽  
Vol 111 (12) ◽  
pp. 453-461 ◽  
Author(s):  
Benedict Hayhoe ◽  
Thomas E Cowling ◽  
Virimchi Pillutla ◽  
Priya Garg ◽  
Azeem Majeed ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Community Health ◽  
Health Worker ◽  
Community Health Workers ◽  
Community Health Worker ◽  
Health Workers ◽  
Pilot Studies ◽  
Cancer Screenings ◽  
Home Based

Objective To model cost and benefit of a national community health worker workforce. Design Modelling exercise based on all general practices in England. Setting United Kingdom National Health Service Primary Care. Participants Not applicable. Data sources Publicly available data on general practice demographics, population density, household size, salary scales and screening and immunisation uptake. Main outcome measures We estimated numbers of community health workers needed, anticipated workload and likely benefits to patients. Results Conservative modelling suggests that 110,585 community health workers would be needed to cover the general practice registered population in England, costing £2.22bn annually. Assuming community health workerss could engage with and successfully refer 20% of eligible unscreened or unimmunised individuals, an additional 753,592 cervical cancer screenings, 365,166 breast cancer screenings and 482,924 bowel cancer screenings could be expected within respective review periods. A total of 16,398 additional children annually could receive their MMR1 at 12 months and 24,716 their MMR2 at five years of age. Community health workerss would also provide home-based health promotion and lifestyle support to patients with chronic disease. Conclusion A scaled community health worker workforce integrated into primary care may be a valuable policy alternative. Pilot studies are required to establish feasibility and impact in NHS primary care.

scholarly journals Needs and challenges of lay community health workers in a palliative care environment for orphans and vulnerable children

2017 ◽  
Vol 22 ◽  
pp. 333-341 ◽  
Author(s):  
Bonita Bernice Visagie ◽  
Jace Pillay
Keyword(s):  
Palliative Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Work Experiences ◽  
Vulnerable Children ◽  
Care Environment ◽  
Knowledge And Skills ◽  
Orphans And Vulnerable Children ◽  
Hiv Aids

Introduction: The escalation of HIV/AIDS infections in the last decade has increased the need for palliative care community organizations to care for orphans and vulnerable children, who are in dire need of support. Many of these organizations depend on the services of lay community health workers to provide constant care to those in need of it in their local communities. The focus of this study is to explore the role of lay health workers in a community organization located in rural Bronkhorstspruit, Gauteng Province of South Africa. That provides palliative care for orphans and vulnerable children diagnosed with HIV/AIDS. Their roles were analysed critically through a job-demands and job-resources theoretical framework.Methods: A descriptive phenomenological case study design was employed to collect data through twenty five individual interviews, two separate focus groups consisting of ten participants in one group and eleven participants in the other group, observations and document analysis. Data were processed through a rigorous thematic analysis.Results: The findings pointed out specific knowledge and skills these lay community health workers needed in order to be satisfied with, and successful in, their administration of palliative care to orphans and vulnerable children. Participants identified the following organizational challenges that were deemed to be impacting negatively on their work experiences: the lack of career pathing processes; sufficient career guidance; and inadequate employment processes, such as staff retention, succession planning, and promotion.Conclusion: Through the findings, a framework for enhancing the work experiences of the lay community health workers was developed. The uniqueness of this framework is that the focus is on improving the work lives of the lay community health workers, who have serious skills-resourcing needs. There were specific concrete strategies that the organization could adopt to support the knowledge and skills requirements of the lay community health workers in relation to the needs and challenges that will enhance their efficiency in the palliative care environment. The findings and framework that emanated from this study could be used to support lay community health workers in their respective organizations to be more effective in the support they provide to orphans and vulnerable children. Because South Africa is afflicted by the HIV/AIDS epidemic, this framework can be used in similar organizations that are working with lay community health workers with skill-resourcing needs not only in the health sector, but also in other sectors, such as in education and agriculture.

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