scholarly journals Feasibility Study of Case-Finding for Breast Cancer by Community Health Workers in Rural Bangladesh

2015 ◽  
Vol 16 (17) ◽  
pp. 7853-7857 ◽  
Author(s):  
Touhidul Imran Chowdhury ◽  
Richard Reed Love ◽  
Mohammad Touhidul Imran Chowdhury ◽  
Abu Saeem Artif ◽  
Hasib Ahsan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Community Health ◽  
Community Health Workers ◽  
Feasibility Study ◽  
Health Workers ◽  
Case Finding ◽  
Rural Bangladesh

scholarly journals An innovative approach to improve the detection and treatment of risk factors in poor urban settings: a feasibility study in Argentina

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Poggio Rosana ◽  
Goodarz Danaei ◽  
Laura Gutierrez ◽  
Ana Cavallo ◽  
María Victoria Lopez ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Primary Care ◽  
Community Health ◽  
Community Health Workers ◽  
Feasibility Study ◽  
Health Workers ◽  
Health Coverage ◽  
Cvd Risk Factors ◽  
Cvd Risk

Abstract Background The effective management of cardiovascular (CVD) prevention among the population with exclusive public health coverage in Argentina is low since less than 30% of the individuals with predicted 10-year CVD risk ≥10% attend a clinical visit for CVD risk factors control in the primary care clinics (PCCs). Methods We conducted a non-controlled feasibility study using a mixed methods approach to evaluate acceptability, adoption and fidelity of a multi-component intervention implemented in the public healthcare system. The eligibility criteria were having exclusive public health coverage, age ≥ 40 years, residence in the PCC’s catchment area and 10-year CVD risk ≥10%. The multi-component intervention addressed (1) system barriers through task shifting among the PCC’s staff, protected medical appointments slots and a new CVD form and (2) Provider barriers through training for primary care physicians and CHW and individual barriers through a home-based intervention delivered by community health workers (CHWs). Results A total of 185 participants were included in the study. Of the total number of eligible participants, 82.2% attended at least one clinical visit for risk factor control. Physicians intensified drug treatment in 77% of participants with BP ≥140/90 mmHg and 79.5% of participants with diabetes, increased the proportion of participants treated according to GCP from 21 to 32.6% in hypertensive participants, 7.4 to 33.3% in high CVD risk and 1.4 to 8.7% in very high CVD risk groups. Mean systolic and diastolic blood pressure were lower at the end of follow up (156.9 to 145.4 mmHg and 92.9 to 88.9 mmHg, respectively) and control of hypertension (BP < 140/90 mmHg) increased from 20.3 to 35.5%. Conclusion The proposed CHWs-led intervention was feasible and well accepted to improve the detection and treatment of risk factors in the poor population with exclusive public health coverage and with moderate or high CVD risk at the primary care setting in Argentina. Task sharing activities with CHWs did not only stimulate teamwork among PCC staff, but it also improved quality of care. This study showed that community health workers could have a more active role in the detection and clinical management of CVD risk factors in low-income communities.

scholarly journals A Randomized Control Trial to Test Effect of Cash Incentives and Training on Active Casefinding for Tuberculosis among Community Health Workers in Nigeria

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1154
Author(s):  
Christie Akwaowo ◽  
Victor Umoh ◽  
Idongesit Umoh ◽  
Eno Usoroh ◽  
Olugbemi Motilewa ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Case Finding ◽  
P Value ◽  
Case Detection ◽  
High Burden ◽  
Cash Incentives ◽  
Case Notification ◽  
And Training

Background: Case detection for Tuberculosis remains low in high burden communities. Community Health Workers (CHWs) are the first point of contact for many Nigerians in the rural areas and have been found useful in active case finding. This study assessed the effect of cash incentives and training on tuberculosis case detection by CHWs in six Local Government Areas in Nigeria. Materials and Methods: A randomised control trial was conducted in three PHC clusters. The intervention Arm (A) received cash incentives for every presumptive case referred. The Training Arm(B) had no cash incentives and the control had neither training nor cash incentives. Case notification rates from the TB program were used to assess the effect of cash incentives on TB case finding. Data was analyzed using Graph Pad Prism. Descriptive data was presented in tables and bivariate data was analyzed using chi square. Mean increases in case notification rates was calculated Statistical significance was set as P=0.05. Results: The intervention identified 394 presumptive TB cases, contributing 30.3% of all presumptive cases notified in the LGAs. Findings also showed an increase of 14.4% (ꭓ2=2.976, P value=0.2258) in case notification rates for the Arm A that received cash incentives alongside training, there was also an increase of 7.4% (ꭓ2= 1.999, P value=0.1575) in Arm B that received Training only. Secondary outcomes indicated a 144.8%(ꭓ2= 4.147, P value=0.1258)  increase in community outreaches conducted in the Arm that were given cash incentives. Conclusion: The study demonstrated an increase in TB control activities of case notification and outreaches among community health workers that received cash incentives and training.  These findings support the use training and cash incentives for CHWs in high burden TB settings to improve TB case detection rates.

scholarly journals Effectiveness of Home-Based Management of Newborn Infections by Community Health Workers in Rural Bangladesh

2009 ◽  
Vol 28 (4) ◽  
pp. 304-310 ◽  
Author(s):  
Abdullah H. Baqui ◽  
Shams E. Arifeen ◽  
Emma K. Williams ◽  
Saifuddin Ahmed ◽  
Ishtiaq Mannan ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Rural Bangladesh ◽  
Home Based

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 Community- based Active Tuberculosis Case Finding in Pastoralist Communities of North-Eastern Uganda

2019 ◽  
pp. 1-10
Author(s):  
Guma Isaac ◽  
Emuron John Robert ◽  
Namugambe Swabrah ◽  
Nabirye Gloria ◽  
Philip Denis Okungura ◽  
...  
Keyword(s):  
Nursing Students ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Case Finding ◽  
Case Detection ◽  
Community Based ◽  
Pastoralist Communities ◽  
Symptom Screening ◽  
Pastoralist Community

Background: Given the global urgency to improve tuberculosis (TB) case detection, a renewed interest in active case finding (ACF) has risen. Missed TB cases pose a serious threat as they continue to fuel TB transmission in the community. We aimed to assess the feasibility of community based ACF for TB among people living in a pastoralist community in Uganda and determine its impact on case detection and treatment uptake. Methods: Between April and May 2019, four third year medical and nursing students placed at Moroto Regional Referral for community orientation worked together with community health workers to conduct a door-to-door survey for TB in pastoralist communities of Nadunget Sub County, Moroto district. The community health workers and the Medical/Nursing students performed symptom screening, collected sputum and facilitated specimen transport to the laboratory. Gene Xpert MTB/RIF assay was performed at the regional referral Hospital for all sputum samples. The community health workers were tasked to follow up on all those clients whose samples turned out to be positive so that they could start treatment as soon as possible. All presumptive cases with negative sputum results were referred to the TB clinic for further evaluation. Results: In one month, we screened 385 individuals and identified 143 aged above 15 years with symptoms suggestive of TB. Among the presumptive cases, 132 (92%) reported a cough of more than two weeks and we were able to obtain sputum samples from 84(58.7%) participants. We diagnosed 11, including 8 bacteriologically confirmed TB cases using Gene Xpert and there was no multidrug resistant case identified. The median time from sputum collection to notification of the positive result was 3 days. All the positive cases were followed up and initiated on treatment. Conclusion: The findings from our study suggest that in a pastoralist community, ACF for TB using a sensitive symptom screen followed by Gene Xpert contributed to improved case detection of TB, shortening the turnaround time hence timely initiation of patients on TB treatment.

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 An Innovative Approach to Improve the Detection and Treatment of Risk Factors in Poor Urban Settings: A Feasibility Study in Argentina

2021 ◽  
Author(s):  
Rosana Poggio ◽  
Goodarz Danaei ◽  
Laura Gutierrez ◽  
Ana Cavallo ◽  
María Lopez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Community Health ◽  
Community Health Workers ◽  
Feasibility Study ◽  
Health Workers ◽  
Public Healthcare ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Clinical Visit

Abstract Background The effective management of cardiovascular (CVD) prevention among the uninsured population in Argentina is low since less than 30% of the individuals with predicted 10-year CVD risk ≥10% attend a clinical visit for CVD risk factors control in the primary care clinics (PCCs). Methods We conducted a non-controlled feasibility study using a mixed methods approach to evaluate acceptability, adoption and fidelity of a multi-component intervention implemented in the public healthcare system. The eligibility criteria were being uninsured, age ≥ 40 years, residence in the PCC´s catchment area and 10-year CVD risk ≥ 10%. The multi-component intervention addressed (1) system barriers through task shifting among the PCC´s staff, protected medical appointments slots and a new CVD form and (2) Provider barriers through training for primary care physicians and CHW and individual barriers through a home-based intervention delivered by community health workers (CHWs).Results A total of 185 participants were included in the study. Of the total number of the eligible participants, 82.2% of eligible participants attended to at least one clinical visit for risk factor control. Physicians intensified drug treatment in 77% of participants with BP ≥140/90 mmHg and 79.5% of participants with diabetes, increased the proportion of participants treated according to GCP from 21% to 32.6% in hypertensive participants, 7.4% to 33.3% in high CVD risk and 1.4% to 8.7% in very high CVD risk groups. Mean systolic and diastolic blood pressure were lower at the end of follow up (156.9 to 145.4 mmHg and 92.9 to 88.9 mmHg, respectively) and control of hypertension (BP<140/90 mmHg) increased from 20.3% to 35.5%.Conclusion The proposed CHWs-led intervention was feasible and well accepted in improving the detection and treatment of risk factors in the uninsured and poor population with moderate or high CVD risk at the primary care setting in Argentina. Task sharing activities with CHWs not only stimulated teamwork among PCC staff, but it also improved quality of care. This study showed that community health workers could have a more active role in the detection and clinical management of CVD risk factors in low-income communities.

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