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 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 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 Integration of Severe Acute Malnutrition Treatment in Primary Health Care Provided by Community Health Workers in Rural Niger

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4067
Author(s):  
Abdias Ogobara Dougnon ◽  
Pilar Charle-Cuéllar ◽  
Fanta Toure ◽  
Abdoul Aziz Gado ◽  
Atté Sanoussi ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Group Treatment ◽  
Outpatient Treatment ◽  
Health Workers ◽  
Severe Acute Malnutrition ◽  
Intervention Group ◽  
Acute Malnutrition ◽  
Control Group ◽  
Treatment Coverage

The present study aimed to assess the effectiveness and impact on treatment coverage of integrating severe acute malnutrition (SAM) treatment at the health hut level by community health workers (CHWs). This study was a non-randomized controlled trial, including two rural communes in the health district of Mayahi: Maïreyreye (control) and Guidan Amoumoune (intervention). The control group received outpatient treatment for uncomplicated SAM from health facilities (HFs), while the intervention group received outpatient treatment for uncomplicated SAM from HFs or CHWs. A total of 2789 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 72.1% in the control group, and 77.2% in the intervention group. Treatment coverage decreased by 8.3% in the control area, while the group of CHWs was able to mitigate that drop and even increase coverage by 3%. This decentralized treatment model of acute malnutrition with CHWs allowed an increase in treatment coverage while maintaining a good quality of care. It also allowed the early inclusion of children in less severe conditions. These results may enhance the Niger Ministry of Health to review the management of SAM protocol and allow CHWs to treat acute malnutrition.

scholarly journals Ongoing training of community health workers in low-income andmiddle-income countries: a systematic scoping review of the literature

BMJ Open ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. e021467 ◽  
Author(s):  
James O’Donovan ◽  
Charles O’Donovan ◽  
Isla Kuhn ◽  
Sonia Ehrlich Sachs ◽  
Niall Winters
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Scoping Review ◽  
Low Income ◽  
Health Workers ◽  
Review Of The Literature ◽  
Ongoing Training

scholarly journals Strategies Used By Community Health Workers to Influence Adoption of Maternal Nutrition Behaviors in Rural Bangladesh: A Focused Ethnographic Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1359-1359
Author(s):  
Gargi Wable Grandner ◽  
Katherine Dickin ◽  
Purnima Menon ◽  
Tiffany Yeh ◽  
John Hoddinott
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Maternal Nutrition ◽  
Health Workers ◽  
Ethnographic Study ◽  
Low Income Countries ◽  
Cultural Congruence ◽  
Healthy Tree ◽  
Diet Diversity

Abstract Objectives Efforts to integrate nutrition into antenatal health promotion in low income countries have led to increased involvement of community health workers (CHWs) in counseling on maternal nutrition. Little is known about how CHWs “package” messages in resource-poor communities to increase adoption of recommended maternal nutrition behaviors. We developed focused ethnographic techniques to explore this. Methods We interviewed 35 randomly selected CHWs providing monthly counseling to pregnant women and their families in 7 ‘Alive & Thrive’ intervention sites in Bangladesh. Two sorting exercises explored CHW strategies for promoting and perceptions of adoption of messages on micronutrient supplements, maternal dietary adequacy, and rest during pregnancy. In-depth probing on messages identified as “difficult” to deliver or adopt revealed how CHWs addressed barriers. Analysis of quantitative sorting data complemented thematic coding of qualitative textual data using grounded theory. Results CHW communication strategies involved 3 themes: feasibility (attitudes, norms, agency, poverty), audience (influence, motivators, support), and linguistic choice (emotional appeals, metaphors, logic, sellable but inaccurate arguments). CHWs viewed micronutrient messages as least difficult to adopt, requiring minimal “packaging”. Dietary messages were moderately difficult to adopt, prompting CHWs to leverage cultural congruence to target family members with different strategies. For example, messaging on diet diversity targeted husbands—the primary food-buyers—with logical arguments highlighting costs of inaction. When mothers-in-law held beliefs restricting gestational food intake, CHWs used metaphors (‘healthy tree, healthy fruit’) or faith-based appeals. Some CHWs used inaccurate messages (‘mother rests, baby rests’) to promote rest during pregnancy because it was seen as the least feasible behavior to adopt. Conclusions Where behavior change is viewed as feasible, CHWs use culturally resonant strategies to enhance adoption of maternal nutrition behaviors. Cultural congruence, or shared beliefs, language and cultural identity, is key to CHW effectiveness, but unhelpful for contextually infeasible behaviors. BCC programs co-designed with CHWs could improve messaging and effectiveness. Funding Sources Cornell AWARE Travel Grant.

Assessing community health workers’ conditions for delivering care to patients in low-income communities

2020 ◽  
Vol 82 ◽  
pp. 102944 ◽  
Author(s):  
Alessandro Jatobá ◽  
Hugo Cesar Bellas ◽  
Bárbara Bulhões ◽  
Isabella Koster ◽  
Rodrigo Arcuri ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Health Workers

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 Screening and Referral for Postpartum Depression among Low-Income Women: A Qualitative Perspective from Community Health Workers

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Rhonda C. Boyd ◽  
Marjie Mogul ◽  
Deena Newman ◽  
James C. Coyne
Keyword(s):  
Mental Health ◽  
Postpartum Depression ◽  
Focus Groups ◽  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Health Workers ◽  
Academic Community ◽  
Barriers And Facilitators ◽  
Postpartum Women

Postpartum depression is a serious and common psychiatric illness. Mothers living in poverty are more likely to be depressed and have greater barriers to accessing treatment than the general population. Mental health utilization is particularly limited for women with postpartum depression and low-income, minority women. As part of an academic-community partnership, focus groups were utilized to examine staff practices, barriers, and facilitators in mental health referrals for women with depression within a community nonprofit agency serving low-income pregnant and postpartum women. The focus groups were analyzed through content analyses and NVIVO-8. Three focus groups with 16 community health workers were conducted. Six themes were identified: (1) screening and referral, (2) facilitators to referral, (3) barriers to referral, (4) culture and language, (5) life events, and (6) support. The study identified several barriers and facilitators for referring postpartum women with depression to mental health services.

Sign in / Sign up

Export Citation Format

Share Document