scholarly journals Improving Community Health Workers’ Attitudes toward Collaborative Practice in the Care of Older Adults: An In-Service Training Intervention Trial in the Philippines

2021 ◽  
Vol 18 (19) ◽  
pp. 9986
Author(s):  
Kathryn Lizbeth L. Siongco ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
TJ Robinson T. Moncatar ◽  
Lourdes Marie S. Tejero ◽  
...  
Keyword(s):  
Older Adults ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Linear Regression Analysis ◽  
The Philippines ◽  
Collaborative Practice ◽  
Control Group ◽  
Multivariate Linear Regression Analysis ◽  
Significant Difference

The objective of this study was to evaluate the efficacy of an in-service, short-term training program in improving the attitudes toward, and readiness and activities for collaboration among community health workers (CHWs) in a primary care setting in the Philippines. A randomized controlled trial was adopted dividing participants into an intervention (n = 42) and a control group (n = 39). Attitudes toward, and readiness and activities for collaboration were measured using three standardized scales before and at 6 months after the training. A significant difference (p < 0.001) was observed in the Attitudes Toward Health Care Teams Scale (ATHCTS) scores between pre- and post-test in the intervention (6.3 ± 8.3 [Mean ± SD]) and control groups (0.7 ± 8.2). Multivariate linear regression analysis showed an independent positive association between the intervention and greater improvement in the ATHCTS score (Coefficient β = 6.17; 95% CI = 0.82, 11.53; p = 0.03) at follow-up, after adjustment for age, years in current occupation, and social support role of participants. The results demonstrated the efficacy of the intervention for improving the attitudes of CHWs toward collaborative practice in the care of older adults.

scholarly journals Effectiveness and Coverage of Treatment for Severe Acute Malnutrition Delivered by Community Health Workers in the Guidimakha Region, Mauritania

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1132
Author(s):  
Pilar Charle-Cuéllar ◽  
Noemí Lopez-Ejeda ◽  
Hassane Toukou Souleymane ◽  
Diagana Yacouba ◽  
Moussa Diagana ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Outpatient Treatment ◽  
Health Workers ◽  
Severe Acute Malnutrition ◽  
Intervention Group ◽  
Acute Malnutrition ◽  
Control Group ◽  
Control Zone ◽  
Significant Difference

Geographical and economic access barriers to health facilities (HF) have been identified as some of the most important causes of the low coverage of severe acute malnutrition (SAM) treatment. The objective of this study is to assess the effectiveness and coverage of SAM treatment delivered by community health workers (CHWs) in the Guidimakha region in Mauritania, compared to the HF based approach. This study was a nonrandomized controlled trial, including two rural areas. The control group received outpatient treatment for uncomplicated SAM from HF, whilst the intervention group received outpatient treatment for uncomplicated SAM from HF or CHWs. A total of 869 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 82.3% in the control group, and 76.4% in the intervention group, we found no significant difference between the groups. Coverage in the intervention zone increased from 53.6% to 71.7%. In contrast, coverage remained at approximately 44% in the control zone from baseline to end-line. This study is the first to demonstrate in Mauritania that the decentralization model of CHWs treating SAM improves acute malnutrition treatment coverage and complies with the international quality standards for community treatment of acute malnutrition. The non-randomized study design may limit the quality of the evidence, but these results could be used by political decision-makers as a first step in revising the protocol for acute malnutrition management.

scholarly journals Impact of Different Levels of Supervision on the Recovery of Severely Malnourished Children Treated by Community Health Workers in Mali

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 367
Author(s):  
Pilar Charle-Cuéllar ◽  
Noemí López-Ejeda ◽  
Mamadou Traore ◽  
Adama Balla Coulibaly ◽  
Aly Landouré ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Community Intervention ◽  
Health Workers ◽  
Acute Malnutrition ◽  
Control Group ◽  
Supportive Supervision ◽  
Supervision Group ◽  
Different Levels

(1) Background: The Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated community case management (iCCM). This paper evaluates the most effective model of supervision for treating SAM using community health workers (CHWs). Methods (2): This study was a prospective non-randomized community intervention trial with two intervention groups and one control group with different levels of supervision. It was conducted in three districts in rural areas of the Kayes Region. In the high supervision group, CHWs received supportive supervision for the iCCM package and nutrition-specific supervision. In the light supervision group, CHWs received supportive supervision based on the iCCM package. The control group had no specific supervision. (3) Results: A total of 6112 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 81.4% in those treated by CHWs in the high supervision group, 86.2% in the light supervision group, and 66.9% in the control group. Children treated by the CHWs who received some supervision had better outcomes than those treated by unsupervised CHWs (p < 0.001). There was no difference between areas with light and high supervision, although those with high supervision performed better in most of the tasks analyzed. (4) Conclusions: Public policies in low-income countries should be adapted, and their model of supervision of CHWs for SAM treatment in the community should be evaluated.

scholarly journals Exploring the Role of Community Health Workers in Providing Cancer Navigation: Perceptions of African American Older Adults

2012 ◽  
Vol 39 (3) ◽  
pp. E288-E298 ◽  
Author(s):  
Jennifer Wenzel ◽  
Randy Jones ◽  
Rachel Klimmek ◽  
Sarah Szanton ◽  
Sharon Krumm
Keyword(s):  
Older Adults ◽  
African American ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
African American Older Adults

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 Effect of tuberculosis training on community health workers’ knowledge: a cluster randomized control trial in South Nigeria

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 837
Author(s):  
Christie Akwaowo ◽  
Idongesit Umoh ◽  
Oluseyi Motilewa ◽  
Victor Umoh ◽  
Eno Usoroh ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Knowledge Score ◽  
Case Finding ◽  
Diagnosis And Treatment ◽  
Randomised Control Trial ◽  
Control Group ◽  
Post Intervention ◽  
Total Knowledge Score

Background: Intensified efforts to improve tuberculosis (TB) diagnosis, treatment, and prevention are needed to meet global EndTB targets. Community health workers’ (CHWs) knowledge with respect to case finding is vital in tuberculosis elimination. This study aimed to determine the effect of tuberculosis training on the knowledge of community health workers in Nigeria. Methods: As part of a larger multicomponent intervention study, a randomised control trial was conducted with CHWs in 18 primary health care (PHC) clusters in Nigeria. The clusters were allocated to three arms: training and cash incentive (A), training only (B), and control (C) arms. Arms (A) and (B) received training on tuberculosis symptoms, prevention, diagnosis and treatment while the control arm (C) did not receive training. Participants’ knowledge on tuberculosis was assessed using questionnaires administered pre- and post-intervention. Data was analyzed using GraphPad Prism. Descriptive data was presented in tables and bivariate data was analyzed using chi square. Statistical significance was set as P<0.05. Results: There was a significant increase in the total knowledge score (25.4%), knowledge of general symptoms (24.4%), prevention (22.6%) and diagnosis and treatment (30.0%) across all study arms post-intervention (p<0.0001). Compared with the control arm, the training arm (A) had a higher proportion of good total knowledge score (94.4%) and arm (B) had a lower proportion of good total knowledge score (83.1%) when compared to the control group (93.1%). These were, however, not statistically significant. Conclusions: An improvement in the CHWs’ knowledge of symptoms, prevention, diagnosis and treatment of tuberculosis was observed after a training intervention was done. Integration of routine tuberculosis training is recommended to improve tuberculosis case finding in high burden communities. Pan African Clinical Trial Registry registration: PACTR202010691865364 (14/01/2020)

scholarly journals Availability of Essential Commodities and Related Bottlenecks for Community Health System: Systematic Literature Review

2020 ◽  
Author(s):  
Ami Pradhan ◽  
Erin Bogue ◽  
Benjamin Schreiber ◽  
Hannah Sarah Dini ◽  
Hitesh Hurkchand ◽  
...  
Keyword(s):  
Literature Review ◽  
Community Health ◽  
Community Health Workers ◽  
Systematic Literature Review ◽  
Health Workers ◽  
Hypothesis Test ◽  
Grey Literature ◽  
National Level ◽  
Health Facilities ◽  
Significant Difference

Abstract Background: This paper explores the extent of community-level stock-out of essential and program commodities for Maternal, Newborn and Child Health (MNCH) among Community Health Workers (CHWs) in Low- and Middle-Income Countries (LMICs), and identifies the underlying bottlenecks leading to such stock-outs.Methods: A systematic literature review was conducted of published and grey literature. 48 studies containing information on the number or percentage of CHWs or health facilities (HFs) stocked-out, or reasons for stock-outs at these levels, were included. In addition, interviews were conducted with domain experts from different organizations working on community health to identify primary reasons for stock-outs. The qualitative data regarding reasons for stock-outs were categorized under different themes, using a content analysis method. Results: 48.09% [CI 95%: 39.28 - 56.90] of the Community Health Workers and 54.76 % [CI 95%: 43.54 - 65.98] of the health facilities in SSA countries included in this study experienced stock-outs of essential commodities. A hypothesis test showed no significant difference in stock-out rates between CHWs and HFs. The most frequently cited reason for CHW stock-outs was a lack of financial resources, leading to inadequate national level stocks, affecting supply available at the last mile. Moreover, issues at HF and CHW levels in the following areas contributed to stock-outs: transportation, data and estimation of needs, human resources, and stock management and storage. These significant bottlenecks hinder the ability of CHWs to save lives.Conclusion: Stock-outs of health commodities impact almost half of CHWs, preventing effective service delivery. Many factors contribute to stock-outs, which occur at all levels of the health supply chain. A system strengthening approach is necessary to reduce CHW stock-outs. Sparse data, differing definitions of stock-outs, and inconsistent reporting metrics posed significant challenges to analyzing results from reviewed studies. Therefore, a set of standard metrics to measure the rate, period, and frequency of stock-outs in future studies is recommended.

scholarly journals Predicting Low Birth Weight: A comparison of Anthropometric Measurements taken by Midwives and Community Health Workers in Uganda

2019 ◽  
Author(s):  
Savino Ayesiga ◽  
Catherine Abaasa ◽  
David Ayebare ◽  
Gakenia Wamuyu-Maina
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Anthropometric Measurements ◽  
Chest Circumference ◽  
Likelihood Ratios ◽  
Significant Difference ◽  
Western Uganda

Abstract Background: In many resource constrained countries, Uganda inclusive, women continue to give birth at home/in the community where there are no weighing scales to measure and record birth weight, and consequently low birth weight remains undetected. Low birth weight, if not urgently detected and attended to reduces chances for growth. This study was to compare newborn anthropometric measurements taken by midwives to those taken by community health workers and to determine cut offs to predict low birth weight in south western Uganda. Methods: A descriptive cross sectional study was conducted between July and September 2017, whereby anthropometric values of 638 newborns born at Mbarara Regional Referral Hospital were measured by two midwives but repeated anthropometric measurements by CHWs were taken only 553 newborns because of loss to follow up. Frequencies, means (standard deviation) were used to describe categorical and continuous demographics of newborns respectively. Pearson correlations were made to test for the associations between main explanatory variables. Specificity, sensitivity, likelihood ratios, diagnostic odds ratios (DOR) and area under the curve (AUC) were used to determine low birth weight at set cut off points of various anthropometric measurements. An independent paired t-test was then conducted to establish whether there was a statistical significant difference between the anthropometric measurements taken by midwives and CHWs. Results: Chest Circumference was the most predictor of low birth weight. Of the 29 (5.2%) low birth weight newborns, chest circumference at a cut off of 30.9 cm was able to predict the highest prevalence of low birth weight as per the anthropometric measurements taken by midwives. Also, anthropometric measurements taken by midwives and those taken by Community Health Workers (CHWs) showed no statistical significant mean differences. Conclusions: Chest circumference is the best predictor of low birth weight in western Uganda. Also, Community Health workers can measure chest circumference with almost the same accuracy like midwives. Keywords: Birth weight, anthropometric predictors, newborns

scholarly journals Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Calistus Wilunda ◽  
Fortihappiness Gabinus Mumba ◽  
Giovanni Putoto ◽  
Gloria Maya ◽  
Elias Musa ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Severe Acute Malnutrition ◽  
Intervention Group ◽  
Control Area ◽  
Acute Malnutrition ◽  
Control Group ◽  
Treatment Coverage ◽  
Quasi Experimental

AbstractHealth system constraints hamper treatment of children with severe acute malnutrition (SAM) in Tanzania. This non-inferiority quasi-experimental study in Bariadi (intervention) and Maswa (control) districts assessed the effectiveness, coverage, and cost-effectiveness of SAM treatment by community health workers (CHWs) compared with outpatient therapeutic care (OTC). We included 154 and 210 children aged 6–59 months with SAM [mid-upper arm circumference (MUAC) < 11.5 cm] without medical complications in the control and intervention districts, respectively. The primary treatment outcome was cure (MUAC ≥ 12.5 cm). We performed costing analysis from the provider’s perspective. The probability of cure was higher in the intervention group (90.5%) than in the control group (75.3%); risk ratio (RR) 1.17; 95% CI 1.05, 1.31 and risk difference (RD) 0.13; 95% CI 0.04, 0.23. SAM treatment coverage was higher in the intervention area (80.9%) than in the control area (41.7%). The cost per child treated was US$146.50 in the intervention group and US$161.62 in the control group and that per child cured was US$161.77 and US$215.49 in the intervention and control groups, respectively. The additional costs per an additional child treated and cured were US$134.40 and US$130.92, respectively. Compared with OTC, treatment of children with uncomplicated SAM by CHWs was effective, increased treatment coverage and was cost-effective.

scholarly journals OPTIMAL HEALTH PROFESSIONAL STAFFING OF PRIMARY CARE AND GERIATRIC PRACTICES SERVING FRAIL OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S66-S66
Author(s):  
Karen Donelan ◽  
Joanne Spetz
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Community Health ◽  
Community Health Workers ◽  
Large Scale ◽  
Assessment Tool ◽  
Health Workers ◽  
Site Assessment ◽  
Frail Older Adults ◽  
Frail Elders

Abstract This symposium will include 3 papers that provide critical interprofessional and interdisciplinary perspectives on our work to understand and measure staffing in health care teams caring for older adults, and frail older adults. The Health Teams for Frail Elders project was funded by the Gordon and Betty Moore Foundation from August 2016 to October 2018. Dr. Karen Donelan, project Principal Investigator, will chair the session, providing a brief project overview of project aims and activities. A survey and health services researcher, Dr. Donelan will set the context for this large scale project. Dr. Barbara Roberge, a geriatric nurse practitioner who established one of the first senior health programs in the nation along with Dr. Kenneth Minaker at Mass General Hospital, was our primary care and nursing lead on our site visits. She will talk about the care settings we visited, her development of a site assessment tool that covered a range of frail elder needs, and will summarize professional roles and staffing observed within different site types. Dr. Julie Berrett-Abebe, a junior investigator on our team (PhD 2017), will present a paper on the competencies and roles of social workers and community health workers in primary and geriatric practices, as well as the roles of community health workers. Dr. David Auerbach, a national expert in health policy and workforce analysis, will present 4 models of staffing of practices, demonstrating efficiencies in optimizing services for frail elders while minimizing costs.Dr. Joanne Spetz will be the discussant of cross-cutting themes.

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