Enhancing the engagement of community health workers in diabetes care: lessons learned from U.S. States and Cities

Background: Despite potential for community health workers (CHWs) to effectively reduce morbidity and mortality in sub-Saharan Africa, they still face multiple barriers including access to on-going and refresher training. Digital technology offers a potential solution to improve the provision of ongoing training for CHWs. Objectives: This report shares participant insights and experiences following the implementation of a mobile health (mHealth) assisted Integrated Community Case Management (iCCM) refresher training programme for CHWs in Mukono, Uganda. We seek to document benefits and challenges of such an approach. Methods: CHWs were trained to recognize, treat and prevent childhood pneumonia via locally made videos preloaded onto low cost, ruggedized Android tablets. Subsequent interviews were compiled with key stakeholders including CHWs, CHW leaders and programme supervisors to better understand the strengths, barriers and lessons learned following the interven- tion. Results: Success factors included the establishment of CHW leadership structures, the ability to use the tablets to learn on an “any pace, any place” basis and using the tablets to conduct community teaching and outreach. Barriers included appro- priate consideration of the implementation timeline and avoiding a “one size fits all” approach to digital literacy training. Conclusions: The strength of the program stemmed from a grassroots approach that prioritized stakeholder input at all stages. Leadership at a local level, a history of local engagement and trust built up over a period time were also integral. As organizations aim to scale up digitally enhanced training initiatives, it is paramount that attention is paid to these human factors which are key for program success. Keywords: Low-cost ruggedized Android tablets; in-service training; community health workers; Mukono.

Download Full-text

Doulas as Community Health Workers: Lessons Learned from a Volunteer Program

The Journal of Perinatal Education ◽

10.1624/105812406x118995 ◽

2006 ◽

Vol 15 (3) ◽

pp. 25-33 ◽

Cited By ~ 16

Author(s):

Lisa Kane Low ◽

Amy Moffat ◽

Patty Brennan

Keyword(s):

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Lessons Learned ◽

Volunteer Program

Download Full-text

Roles for community health workers in diabetes prevention and management in low- and middle-income countries

Cadernos de Saúde Pública ◽

10.1590/0102-311x00287120 ◽

2021 ◽

Vol 37 (10) ◽

Author(s):

Masih A. Babagoli ◽

Ramfis Nieto-Martínez ◽

Juan P. González-Rivas ◽

Kavita Sivaramakrishnan ◽

Jeffrey I Mechanick

Keyword(s):

Chronic Disease ◽

Community Health ◽

Community Health Workers ◽

Health Systems ◽

Diabetes Care ◽

Health Workers ◽

Noncommunicable Disease ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Diabetes prevalence is increasing worldwide, especially in low- and middle-income countries (LMIC), posing the need for improved detection and management strategies. Chronic disease models and lifestyle medicine provide structures for action. Community health workers (CHWs) can significantly contribute to chronic disease care if they are trained and integrated into low-resource health systems. Although most current CHWs worldwide are performing maternal/child health and infectious disease-related tasks, other programs involving CHWs for noncommunicable disease prevention and management are increasing. In this article, we discuss the advantages, challenges, and questions regarding possible roles assigned to CHWs in the prevention and management of diabetes. These roles include performing simple screening tests, implementing lifestyle/behavioral interventions, and connecting patients with alternatives to biomedicine. Specifically, CHWs can aid diabetes epidemiological surveillance by conducting risk score-based screening or capillary glucose testing, and they can facilitate diabetes self-management by delivering interventions described in the transcultural diabetes nutrition algorithm. Furthermore, while this role has not formally been assigned, CHWs can leverage their intimate knowledge of local practices to provide decision-making support to patients in environments with pluralistic health systems. Ethnocultural differences in CHW functions and transcultural adaptations of their roles in diabetes care should also be considered. In summary, CHWs can improve diabetes care by screening high-risk individuals and implementing lifestyle interventions, especially in LMIC.

Download Full-text