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Community Health Worker AND Workload

Ann M Weber, Emanuela Galasso, Lia C H Fernald
Scaling up integrated nutrition programmes from small, targeted interventions or pilot studies to large-scale government-run programmes can be challenging, with risks of changing the nature and quality of the interventions such that effectiveness is not sustained. In 1999, the Government of Madagascar introduced a nationwide, community-based, growth-monitoring and nutrition education programme, which was gradually scaled up throughout the country until 2011. Data from three nationally representative surveys, administered pre- and post-programme implementation, in participating and non-participating communities, were used to evaluate the effectiveness of the programme to reduce malnutrition in children under 5 after two phases of expansion (1999-2004 and 2004-2011)...
January 2019: Maternal & Child Nutrition
Ruth Jackson
Background: Quantitative research is useful for answering 'how many' or 'how much' questions, while qualitative research helps answer 'why' and 'how' questions. Most research about health extension workers (HEWs) has been quantitative and few studies examine the experiences of HEWs themselves. This qualitative study draws attention to the gendered dynamics of human resources for health at the community level. Methods: Focus Group Discussions (FGDs) with 14 HEWs (two FGDs in Afar Region and two in Southern Nations Nationality and Peoples Region), and interviews with 45 HEWs from Afar Region, SNNPR and Adwa (Tigray Region) were conducted to identify how gender issues affected their well-being...
September 2018: Ethiopian Journal of Health Sciences
Katharine D Shelley, Gasto Frumence, Rose Mpembeni, Asha S George, Elizabeth A Stuart, Japhet Killewo, Abdullah H Baqui, David H Peters
Community health workers (CHWs) play a critical role in health promotion, but their workload is often oriented around a single disease. Renewed interest in expansion of multipurpose CHWs to cover an integrated package of services must contend with the debate over how effectively CHWs can perform an increased range of tasks. In this study, we examine whether an existing cadre of HIV-focused paid volunteer CHWs in Iringa, Tanzania, can take on new maternal, newborn and child health (MNCH) promotion tasks without adversely affecting their HIV role...
December 26, 2018: Health Policy and Planning
Thandile Nkosi-Gondwe, Bjarne Robberstad, Björn Blomberg, Kamija S Phiri, Siri Lange
BACKGROUND: Severe malarial anaemia is one of the leading causes of paediatric hospital admissions in Malawi. Post-discharge malaria chemoprevention (PMC) is the intermittent administration of full treatment courses of antimalarial to children recovering from severe anaemia and findings suggest that this intervention significantly reduces readmissions and deaths in these children. Community delivery of health interventions utilizing community health workers (CHWs) has been successful in some programmes and not very positive in others...
December 19, 2018: BMC Health Services Research
W Mengesha, R Steege, A Z Kea, S Theobald, D G Datiko
Background: Health extension workers (HEWs) are the key cadre within the Ethiopian Health Extension Programme extending health care to rural communities. National policy guidance supports the use of mHealth to improve data quality and use. We report on a mobile Health Management Information system (HMIS) with HEWs and assess its impact on data use, community health service provision and HEWs' experiences. Methodology: We used a mixed methods approach, including an iterative process of intervention development for 2 out of 16 essential packages of health services, quantitative analysis of new registrations, and qualitative research with HEWs and their supervisors...
December 1, 2018: Journal of Public Health
Samiksha Singh, Neha Dwivedi, Amol Dongre, Pradeep Deshmukh, Deepak Dey, Vijay Kumar, Sanjeev Upadhyaya
BACKGROUND: Auxillary nurse midwives (ANMs) are the most important frontline multi-purpose workers in rural India. This study was conducted to assess the spectrum of service delivery, time utilisation, work planning, and factors affecting functioning of ANMs in South India. METHODS: We conducted a time and motion study in three districts across two states in South India. The districts selected in such a manner that they had a considerable tribal population. We conducted multi-stage sampling to select ANMs...
November 26, 2018: Human Resources for Health
Alison Wringe, Caoimhe Cawley, Elisabeth Szumilin, Leon Salumu, Isabel Amoros Quiles, Estelle Pasquier, Charles Masiku, Sarala Nicholas
INTRODUCTION: Longer intervals between clinic consultations for clinically stable antiretroviral therapy (ART) patients may improve retention in care and reduce facility workload. We assessed long-term retention among clinically stable ART patients attending six-monthly clinical consultations (SMCC) with three-monthly fast-track drug refills, and estimated the number of consultations "saved" by this model of ART delivery in rural Malawi. METHODS: Stable patients (aged ≥18 years, on first-line ART ≥12 months, CD4 count ≥300 cells/mL3 , without opportunistic infections, not pregnant/breastfeeding) were eligible for SMCC, with three-monthly drug refills from community health workers...
November 2018: Journal of the International AIDS Society
Daudi Omari Simba, Deodatus Kakoko, Tumaini Nyamhanga, Zakayo Mrango, Phare Mujinja
Purpose: Improving access to malaria treatment in rural remote areas remains a major challenge facing innovative strategies, such as Accredited Drug Dispensing Outlets (ADDOs) and Community Health Workers (CHWs) programs in Tanzania. This study tested the effectiveness of a financial benefit approach to motivate CHWs to improve prompt access to malaria treatment. Patients and methods: We applied a quasi-experimental study design in rural-remote areas in Kilosa district, Tanzania...
2018: Research and Reports in Tropical Medicine
Benedict Hayhoe, Thomas E Cowling, Virimchi Pillutla, Priya Garg, Azeem Majeed, Matthew Harris
Objective To model cost and benefit of a national community health worker workforce. Design Modelling exercise based on all general practices in England. Setting United Kingdom National Health Service Primary Care. Participants Not applicable. Data sources Publicly available data on general practice demographics, population density, household size, salary scales and screening and immunisation uptake. Main outcome measures We estimated numbers of community health workers needed, anticipated workload and likely benefits to patients...
October 4, 2018: Journal of the Royal Society of Medicine
Jennifer Wesson, Ndapewa Hamunime, Claire Viadro, Martha Carlough, Puumue Katjiuanjo, Pamela McQuide, Pearl Kalimugogo
BACKGROUND: Disrespectful and abusive maternity care is a complex phenomenon. In Namibia, HIV and high maternal mortality ratios make it vital to understand factors affecting maternity care quality. We report on two studies commissioned by Namibia's Ministry of Health and Social Services. A health worker study examined cultural and structural factors that influence maternity care workers' attitudes and practices, and a maternal and neonatal mortality study explored community perceptions about maternity care...
September 5, 2018: BMC Pregnancy and Childbirth
Tonya R Thurman, Tory M Taylor, Johanna Nice, Brian Luckett, Myra Taylor, J D Kvalsvig
BACKGROUND: Child and youth care workers (CYCWs) are a crucial and growing component of South Africa's national response to HIV and AIDS and other issues affecting children and families. CYCWs use the community-centred Isibindi model of care to reach the most vulnerable with key services including psychosocial, health, economic and education support. Like others in similar professions, they may be at risk for occupational challenges affecting retention. METHODS: This study uses data from the first nationally representative survey of CYCWs in South Africa to identify factors associated with workers' retention intentions...
August 29, 2018: Human Resources for Health
Yared Amare, Pauline Scheelbeek, Joanna Schellenberg, Della Berhanu, Zelee Hill
BACKGROUND: Timely interventions in the postnatal period are important for reducing newborn mortality, and early home visits to provide postnatal care are recommended. There has been limited success in achieving timely visits, and a better understanding of the realities of programmes is needed if improvements are to be made. METHODS: We explored barriers and facilitators to timely postnatal visits through 20 qualitative interviews and 16 focus group discussions with families and Health Extension Workers in four Ethiopian sites...
August 29, 2018: BMC Public Health
Mariana Curotto, Julieta Zalacaín-Colombo, Melisa Paolino, Silvina Arrossi
OBJECTIVE: To evaluate adoption and implementation of scaling up of HPV self-collection (SC) strategy offered doorto-door by Community Health Workers (CHWs) in Jujuy, Argentina. MATERIALS AND METHODS: A self-administered questionnaire was applied to 478 CHWs.RE-AIM model was used to evaluate adoption and implementation dimensions. RESULTS: Results. Adoption:81.8% offered SC and 86.4% were satisfied with the strategy. Implementation: main problems were delays in the delivery of tubes (61...
April 4, 2018: Salud Pública de México
Anthony K Ngugi, Lucy W Nyaga, Amyn Lakhani, Felix Agoi, Margrette Hanselman, George Lugogo, Kala M Mehta
Introduction: In underserved populations, the contribution of community health workers (CHWs) is vital to the healthcare systems. Attrition of these workers causes critical breakdowns in the delivery of essential services to these populations. Literature on reasons for attrition is limited, although some have been identified in studies on sustainability of CHW programmes. These factors are, however, likely to be influenced by context. We measured CHW attrition and its predictors in a rural area in Kenya...
2018: BMJ Global Health
Sagar Dugani, Henrietta Afari, Lisa R Hirschhorn, Hannah Ratcliffe, Jeremy Veillard, Gayle Martin, Gina Lagomarsino, Lopa Basu, Asaf Bitton
Background: Primary health care (PHC) systems require motivated and well-trained frontline providers, but are increasingly challenged by the growing global shortage of health care workers. Burnout, defined as emotional exhaustion, depersonalization, and low personal achievement, negatively impacts motivation and may further decrease productivity of already limited workforces. The objective of this review was to analyze the prevalence of and factors associated with provider burnout in low and middle-income countries (LMICs)...
June 11, 2018: Gates open research
Helen Mwiinga Chipukuma, Joseph Mumba Zulu, Choolwe Jacobs, Gershom Chongwe, Mumbi Chola, Hikabasa Halwiindi, Jessy Zgambo, Charles Michelo
BACKGROUND: Community health workers (CHWs) are an important human resource in improving coverage of and success to interventions aimed at reducing malaria incidence. Evidence suggests that the performance of CHWs in malaria programs varies in different contexts. However, comprehensive frameworks, based on systematic reviews, to guide the analysis of determinants of performance of CHWs in malaria prevention and control programs are lacking. METHODS: We systematically searched Google Scholar, Science Direct, and PubMed including reference lists that had English language publications...
May 8, 2018: Human Resources for Health
Dong-Woo Choi, Sung-Youn Chun, Sang Ah Lee, Kyu-Tae Han, Eun-Cheol Park
The aim of this study was to find the association between sleep duration and perceived stress in salaried workers according to occupational categories and which lifestyle factors affected those correlations in South Korea. This study used data from the 2015 Community Health Survey (CHS). The self-reported sleep duration was used as the dependent variable in this study. We explored sleep duration and stress awareness among salaried workers, as well as household income and educational level with multiple logistic regression analysis...
April 19, 2018: International Journal of Environmental Research and Public Health
Aurélie Brunie, Patricia N W Mucheri, Angela Akol, Mario Chen, Sarah J Mercer, Tricia Petruney
Little is known on integrating HIV and family planning (FP) services in community settings. Using a cluster randomized controlled design, we conducted a formative assessment in two districts in Uganda where community health workers, called VHTs, already offered FP. Thirty-six trained VHTs also provided HIV testing and counseling (HTC) during the intervention. We surveyed all 36 VHTs and 256 FP clients, and reviewed service statistics. In the intervention group, VHTs tested 80% of surveyed clients for HIV, including 76% they already saw for FP and 22% who first came to them for HTC before receiving FP...
June 2017: African Journal of Reproductive Health
Joanna Morrison, Issarapa Chunsuwan, Petch Bunnag, Petra C Gronholm, Georgia Lockwood Estrin
Introduction: In low-income and middle-income countries, it is estimated that one in every three preschool-age children are failing to meet cognitive or socioemotional developmental milestones. Thailand has implemented a universal national developmental screening programme (DSPM) for young children to enable detection of developmental disorders and early intervention that can improve child health outcomes. DSPM implementation is being hampered by low attendance at follow-up appointments when children fail the initial screening...
2018: BMJ Global Health
Rangarirai Matima, Katherine Murphy, Naomi S Levitt, Rhonda BeLue, Tolu Oni
BACKGROUND: Current South African health policy for chronic disease management proposes integration of chronic services for better outcomes for chronic conditions; that is based on the Integrated Chronic Disease Model (ICDM). However, scant data exist on how patients with chronic multimorbidities currently experience the (re)-organisation of health services and what their perceived needs are in order to enhance the management of their conditions. METHODS: A qualitative study was conducted in a community health centre treating both HIV and diabetes patients in Cape Town...
2018: PloS One
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