scholarly journals The Impact of Peer Educators or Community Health Workers on the Progress of the UNAIDS 90-90-90 Targets in Africa: A Systematic Review and Meta-Analysis Protocol

2021 ◽  
Vol 18 (8) ◽  
pp. 3917
Author(s):  
Hafte Kahsay Kebede ◽  
Hailay Abrha Gesesew ◽  
Lillian Mwanri ◽  
Paul Ward
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Hiv And Aids ◽  
Hiv Care ◽  
Primary Data ◽  
Peer Educators ◽  
The Impact

Background: Africa is far behind from achieving the Joint United Nations Program on HIV and AIDS (UNAIDS) 90-90-90 targets. Evidence shows that the participation of HIV patients as peer educators and other community health workers is substantially improving the entire HIV care continuum and subsequently the UNAIDS targets. This review aims to provide the best available evidence on the impact of peer educators and/or community health workers for the three targets in Africa. Methods: We will include cohort and experimental studies published in English between 2003 and 2020. Studies which reported interventions for HIV diagnosis, initiation of ART, or virological suppression will be included for review. Three steps searching will be conducted: (i) initial search across Google Scholar, (ii) full search strategy across five databases: MEDLINE, PubMed, CINAHL, SCOPUS and Web of Science, and (iii) screening titles and abstracts. Data will be extracted using standardized instruments from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and analyzed through narrative synthesis, and meta-analyses and regression. Heterogeneity among quantitative studies will be assessed using Cochran Q test and Higgins I2. Ethics: A formal ethical approval will not be required as primary data will not be collected.

scholarly journals Community Health Workers Working the Digital Archive: A Case for Looking at Participatory Archiving in Studying Stigma in the Context of HIV and AIDS

2012 ◽  
Vol 17 (1) ◽  
pp. 13-28 ◽  
Author(s):  
Naydene De Lange ◽  
Claudia Mitchell
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Hiv And Aids ◽  
Hiv Stigma ◽  
Digital Archive ◽  
Visual Data ◽  
Community Members ◽  
Work Related ◽  
Kwazulu Natal

Addressing the issue of HIV-stigma is recognised as essential to reducing the spread of HIV and AIDS, enabling community members to access prevention, treatment and care. Often the very people who are able to contribute to solving the problem, are marginalised and do not see ways to insert themselves into dialogues related to combating stigma. Community health workers in rural South Africa are one such group. At the heart of the research discussed in this article is an intervention based on participatory analysis through participatory archiving ( Shilton and Srinivasan 2008 ). Drawing on participatory work with thirteen community health workers in rural KwaZulu-Natal, we use a digital archive containing HIV-stigma visual data - generated five years earlier by youth in the community - to engage the participants in the analysis. Drawing on such participatory work as Jenkins’ participatory cultures framework, we focus on the idea of re-using, re-coding, and re-mixing visual data. One participant stated that “these pictures talk about the real issues faced by our communities”, highlighting the value of resources generated by community members themselves. They also indicate that they “could use [the resources] to teach the cons of stigmatising”. A key concern in work related to visual images (particularly in projects such as ours where a large amount of visual data is produced) is to consider ways of extending its life through the use of community-based digital archives.

Integrating community health workers into HIV care teams: Impact on HIV care outcomes

2020 ◽  
Vol 19 (3) ◽  
pp. 204-219
Author(s):  
Mari-Lynn Drainoni ◽  
Allyson L. Baughman ◽  
Sara S. Bachman ◽  
Rachel Bowers-Sword ◽  
Melissa Davoust ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Hiv Care ◽  
Care Outcomes

scholarly journals Connecting communities to primary care: a qualitative study on the roles, motivations and lived experiences of community health workers in the Philippines

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eunice Mallari ◽  
Gideon Lasco ◽  
Don Jervis Sayman ◽  
Arianna Maever L. Amit ◽  
Dina Balabanova ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Health ◽  
Community Health Workers ◽  
Financial Incentives ◽  
Lived Experiences ◽  
Health Workers ◽  
The Philippines ◽  
Community Members ◽  
Cross Sectional ◽  
The Impact

Abstract Background Community health workers (CHWs) are an important cadre of the primary health care (PHC) workforce in many low- and middle-income countries (LMICs). The Philippines was an early adopter of the CHW model for the delivery of PHC, launching the Barangay (village) Health Worker (BHW) programme in the early 1980s, yet little is known about the factors that motivate and sustain BHWs’ largely voluntary involvement. This study aims to address this gap by examining the lived experiences and roles of BHWs in urban and rural sites in the Philippines. Methods This cross-sectional qualitative study draws on 23 semi-structured interviews held with BHWs from barangays in Valenzuela City (urban) and Quezon province (rural). A mixed inductive/ deductive approach was taken to generate themes, which were interpreted according to a theoretical framework of community mobilisation to understand how characteristics of the social context in which the BHW programme operates act as facilitators or barriers for community members to volunteer as BHWs. Results Interviewees identified a range of motivating factors to seek and sustain their BHW roles, including a variety of financial and non-financial incentives, gaining technical knowledge and skill, improving the health and wellbeing of community members, and increasing one’s social position. Furthermore, ensuring BHWs have adequate support and resources (e.g. allowances, medicine stocks) to execute their duties, and can contribute to decisions on their role in delivering community health services could increase both community participation and the overall impact of the BHW programme. Conclusions These findings underscore the importance of the symbolic, material and relational factors that influence community members to participate in CHW programmes. The lessons drawn could help to improve the impact and sustainability of similar programmes in other parts of the Philippines and that are currently being developed or strengthened in other LMICs.

scholarly journals Delivering comprehensive HIV services across the HIV care continuum: a comparative analysis of survival and progress towards 90-90-90 in rural Malawi

2018 ◽  
Vol 3 (1) ◽  
pp. e000552 ◽  
Author(s):  
Emily B Wroe ◽  
Elizabeth L Dunbar ◽  
Noel Kalanga ◽  
Luckson Dullie ◽  
Chiyembekezo Kachimanga ◽  
...  
Keyword(s):  
Community Health ◽  
Social Determinants Of Health ◽  
Community Health Workers ◽  
Health Systems ◽  
Social Determinants ◽  
Health Workers ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Facility Level

IntroductionPartners In Health and the Malawi Ministry of Health collaborate on comprehensive HIV services in Neno, Malawi, featuring community health workers, interventions addressing social determinants of health and health systems strengthening. We conducted an observational study to describe the HIV care continuum in Neno and to compare facility-level HIV outcomes against health facilities nationally.MethodsWe compared facility-level outcomes in Neno (n=13) with all other districts (n=682) from 2013 to 2015 using mixed-effects linear regression modelling. We selected four outcomes that are practically useful and roughly mapped on to the 90-90-90 targets: facility-based HIV screenings relative to population, new antiretroviral therapy (ART)enrolments relative to population, 1-year survival rates and per cent retained in care at 1 year.ResultsIn 2013, the average number of HIV tests performed, as a per cent of the adult population, was 11.75%, while the average newly enrolled patients was 10.03%. Percent receiving testing increased by 4.23% over 3 years (P<0.001, 95% CI 2.98% to 5.49%), while percent enrolled did not change (P=0.28). These results did not differ between Neno and other districts (P=0.52), despite Neno having a higher proportion of expected patients enrolled. In 2013, the average ART 1-year survival was 80.41% nationally and 91.51% in Neno, which is 11.10% higher (P=0.002, 95% CI 4.13% to 18.07%). One-year survival declined by 1.75% from 2013 to 2015 (P<0.001, 95% CI −2.61% to −0.89%); this was similar in Neno (P=0.83). Facility-level 1-year retention was 85.43% nationally in 2013 (P<0.001, 95% CI 84.2% to 86.62%) and 12.07% higher at 97.50% in Neno (P=0.001, 95% CI 5.08% to19.05%). Retention declined by 2.92% (P<0.001, 95% CI −3.69% to −2.14%) between 2013 and 2015, both nationally and in Neno.ConclusionThe Neno HIV programme demonstrated significantly higher survival and retention rates compared with all other districts in Malawi. Incorporating community health workers, strengthening health systems and addressing social determinants of health within the HIV programme may help Malawi and other countries accelerate progress towards 90-90-90.

scholarly journals How Can We Improve the Consumption of a Nutritionally-Balanced Maternal Diet in Rural Bangladesh? The Key Elements of the ‘Balanced Plate’ Intervention

2020 ◽  
Author(s):  
Ashraful Alam ◽  
Morseda Chowdhury ◽  
Michael John Dibley ◽  
Camille Raynes-Greenow
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Controlled Trial ◽  
Maternal Diet ◽  
Intervention Strategy ◽  
Rural Bangladesh ◽  
Portion Sizes ◽  
The Impact ◽  
Practical Demonstration

Social, cultural, environmental and economic factors closely regulate the selection, allocation and consumption of maternal diets. We developed a nutrition behaviour change intervention to promote a balanced diet in pregnancy through practical demonstration in rural Bangladesh and tested the impact with a cluster randomised controlled trial. This paper presents the findings of the process evaluation and describes the strategies that worked for intervention compliance. We conducted in-depth interviews with pregnant women, women who birthed recently, and their husbands; focus groups with mothers and mothers-in-law; key-informant interviews with community health workers, and observation of home visits. We identified six key areas within the intervention strategy that played a crucial role in achieving the desired adherence. These included practical demonstration of portion sizes; addressing local food perceptions; demystifying animal-source foods; engaging husbands and mothers-in-law; leveraging women&rsquo;s social networks; and harnessing community health workers&rsquo; social role. Practical demonstration, opportunity to participate and convenience of making of the plate with the food available in their kitchen or neighbours&rsquo; kitchen were the most commonly mentioned reasons for acceptance of the intervention by the women and their families. The balanced plate intervention helped women through practical demonstration to learn about a balanced meal by highlighting appropriate portion sizes and food diversity. The women needed active involvement of community health workers in mobilising social support to create an enabling environment essential to bring changes in dietary behaviours. Programs to promote a nutritious maternal diet should focus on encouraging the use of healthy foods through practical demonstration of portion sizes and engagement of the women and family instead of replicating the traditional information-based counselling.

scholarly journals Long-Term Impact of Single Epilepsy Training on Knowledge, Attitude and Practices: Comparison of Trained and Untrained Rwandan Community Health Workers

2021 ◽  
Vol 66 ◽  
Author(s):  
Peter Dedeken ◽  
Stephen N. Muhumuza ◽  
Fidele Sebera ◽  
Josiane Umwiringirwa ◽  
Leopold Bitunguhari ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Multivariate Analyses ◽  
Health Workers ◽  
Demographic Differences ◽  
Negative Attitudes ◽  
Related Stigma ◽  
Long Term Impact ◽  
The Impact

Objectives: To close the epilepsy treatment gap and reduce related stigma, eradication of misconceptions is importantIn 2014, Community Health Workers (CHWs) from Musanze (Northern Rwanda) were trained on different aspects of epilepsy. This study compared knowledge, attitude and practices (KAPs) towards epilepsy of trained CHWs 3 years after training, to untrained CHWs from Rwamagana (Eastern Rwanda).Methods: An epilepsy KAP questionnaire was administered to 96 trained and 103 untrained CHWs. Demographic and intergroup KAP differences were analysed by response frequencies. A multivariate analyses was performed based on desired and undesired response categories.Results: Epilepsy awareness was high in both groups, with better knowledge levels in trained CHWs. Negative attitudes were lowest in trained CHWs, yet 17% still reported misconceptions. Multivariate analysis demonstrated the impact of the training, irrespective of age, gender and educational level. Knowing someone with epilepsy significantly induced more desired attitudes.Conclusion: Despite demographic differences between trained and untrained CHWs, a single epilepsy training resulted in significant improvement of desired KAPs after 3 years. Nation-wide CHW training programs with focus on training-resistant items, e.g., attitudes, are recommended.

scholarly journals Reactions of community members regarding community health workers’ activities as a measure of the impact of a training program in Amazonas, Brazil

2015 ◽  
Vol 10 (1) ◽  
pp. 7-19 ◽  
Author(s):  
Ryoko Kawasaki ◽  
Toru Sadamori ◽  
Terezinha Ferreira de Almeida ◽  
Megumi Akiyoshi ◽  
Mika Nishihara ◽  
...  
Keyword(s):  
Community Health ◽  
Training Program ◽  
Community Health Workers ◽  
Health Workers ◽  
Community Members ◽  
The Impact
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