HOW EFFECTIVELY DO COMMUNITY HEALTH WORKERS SPREAD HEALTH AWARENESS VIA WOMEN’S SELF-HELP GROUPS IN RURAL INDIA?

In many lower- and middle-income countries, the public health system is made more accessible in rural areas through training lay people to become community health workers (CHWs) within their communities. This mixed-methods study aims to evaluate such a CHW program in rural Uttarkashi, India, which is being run by a non-government organization (NGO). In the CHW program to be evaluated, the CHWs give monthly health awareness classes during women’s self-help group (SHG) meetings. By involving women’s SHGs, community participation is supposed to be fostered and health knowledge spread. Therefore, it was hypothesized that communities with an active CHW should achieve a higher number of correct answers on a health knowledge test than communities without an active CHW. Moreover, using qualitative methods, we explored the SHG members’ and CHWs’ viewpoints on the impact of the awareness classes held during SHG meetings. Five focus group discussions were conducted with members of SHGs, as well as with NGO-trained CHWs and government-employed CHWs. Results confirmed that the respondents from a community with an NGO-trained CHW performed significantly better on the health knowledge test, although not uniformly across all sampling areas. The qualitative data revealed a substantial impact of the health awareness classes on behavior changes among SHG members and their families. Further, the NGO-trained CHWs collaborated well with other government-employed CHWs. In conclusion, the authors feel that is would be worthwhile to employ more NGO-run CHW programs throughout India, to supplement the government-run programs, especially in remote and underserviced areas.

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Assessment of relevance and effectiveness of community health workforce (CHW) development system in Bangladesh

Northern International Medical College Journal ◽

10.3329/nimcj.v5i2.23129 ◽

2015 ◽

Vol 5 (2) ◽

pp. 332-335

Author(s):

Md Humayun Kabir Talukder ◽

BH Nazma Yasmeen ◽

Rumana Nazneen ◽

Md Zakir Hossain ◽

Ishrat Jahan Chowdhury

Keyword(s):

Community Health ◽

Community Health Workers ◽

Health Workforce ◽

Rural Areas ◽

Ethical Issues ◽

Health Workers ◽

Care Delivery ◽

Cross Sectional ◽

Development System ◽

Audiovisual Aids

Background : Community Health Workforce (CHW) development has a rich history in South East Asian Region (SEAR). The first Community Health Unit was established in Sri Lanka in 1926 and then practiced over many of the regional countries like, Thailand, Mayanmar and India. Community Health Workers are in the fore front workforce to bring about change through community health programmes to national levels. In Bangladesh, there are also different categories of health workforce serving in the health care delivery system.Objectives : To assess relevance and effectiveness of community health workforce (CHW) development system in Bangladesh.Methods : This cross sectional study was conducted from 1st November 2010-30th April 2011 by purposive sampling technique. Study population were directors, administrators, principals, teachers of different institutes/ organizations and community health workers working in different corners of Bangladesh. Study places were different divisional towns of Bangladesh. Previously developed questionnaire & checklist were used for the collection of data from the institutes/ organizations by data collectors. These data were edited, processed and was analysed by using SPSS soft ware and a small portion by manually. No strong ethical issues were involved in this activity.Results : Study revealed that all the respondents (100%) are in favour of production of CHW in Bangladesh through formal academic institutional or pre service education (61.4%) .Most of the respondents (56.8%) viewed that there are scopes of utilisation of produced CHW in rural areas and most of the respondents (63.6%) also viewed that terminal/marginalized/underprivileged peoples of hard to reach areas at least can be served by CHW. Regarding the competency of produced CHW few of the respondents (43.2%) viewed positively. Most of the respondents (86.4%) viewed that both govt. & non govt. sectors should produce CHW with a very good coordination and co-operation. Study revealed the institutional capacities or situations about physical facilities, ongoing course, audiovisual aids, library, manpower and assessment procedure.Conclusion : Study revealed that there is strong & logical relevance present for the production of CHW in Bangladesh. So the existing Human Resource for Health (HRH) policy is to be revised & revisited as a time felt need to develop more competent CHW for Bangladesh to serve the marginalized, terminal, people of remote, rural & hard to reach areas.Northern International Medical College Journal Vol.5(2) 2014: 332-335

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Surveillance of Noncommunicable Diseases by Community Health Workers in Kerala: The Epidemiology of Noncommunicable Diseases in Rural Areas (ENDIRA) Study

Global Heart ◽

10.1016/j.gheart.2014.07.003 ◽

2014 ◽

Vol 9 (4) ◽

pp. 409 ◽

Cited By ~ 10

Author(s):

Jaideep Menon ◽

Jacob Joseph ◽

Ajit Thachil ◽

Thankachan V. Attacheril ◽

Amitava Banerjee

Keyword(s):

Community Health ◽

Community Health Workers ◽

Rural Areas ◽

Health Workers ◽

Noncommunicable Diseases

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

BMC Health Services Research ◽

10.1186/s12913-020-05699-0 ◽

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.

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Community health workers: to train or to restrain? A longitudinal survey to assess the impact of training community health workers in the Bolama Region, Guinea-Bissau

Human Resources for Health ◽

10.1186/1478-4491-12-8 ◽

2014 ◽

Vol 12 (1) ◽

Cited By ~ 17

Author(s):

Sérgio C Lopes ◽

António J Cabral ◽

Bruno de Sousa

Keyword(s):

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Longitudinal Survey ◽

Guinea Bissau ◽

Training Community ◽

The Impact

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Community Health Workers Versus Nurses as Counselors or Case Managers in a Self-Help Diabetes Management Program

American Journal of Public Health ◽

10.2105/ajph.2016.303054 ◽

2016 ◽

Vol 106 (6) ◽

pp. 1052-1058 ◽

Cited By ~ 14

Author(s):

Kim B. Kim ◽

Miyong T. Kim ◽

Hochang B. Lee ◽

Tam Nguyen ◽

Lee R. Bone ◽

...

Keyword(s):

Community Health ◽

Community Health Workers ◽

Diabetes Management ◽

Health Workers ◽

Management Program ◽

Case Managers ◽

Self Help ◽

Diabetes Management Program

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

10.20944/preprints202007.0197.v1 ◽

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’s social networks; and harnessing community health workers’ social role. Practical demonstration, opportunity to participate and convenience of making of the plate with the food available in their kitchen or neighbours’ 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.

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

International Journal of Public Health ◽

10.3389/ijph.2021.645598 ◽

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.

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