Community Interventions

This report examines approaches for the community management of sick children, specifically antimicrobial treatment, through the use of community health workers or their equivalent. It is based on an extensive review of literature, including peer-reviewed studies, reports, programme descriptions and program evaluations. [from introduction]

This article assesses the effectiveness of village health volunteers in performing early diagnosis and treatment to reduce the burden of malaria in Loa PDR. [adapted from abstract]

This article presents a model for the development of sustainable primary health care in village communities in Honduras through the training and support of community health workers. [from author]

This study examined evidence from randomized control trials on community health worker interventions in management of childhood illnesses from a realist perspective to gain insight into how these interventions work. [adapted from abstract]

Home Management of Malaria (HMM) is a strategy to improve acces to appropriate and effective malaria treatment in the community or home through early recognition of malaria symptoms and prompt treatment. To do this, volunteer members of the communities are trained to recognize fever, to administer treatment to children under five years of age when they find it, and to advise on follow-up treatment and prevention. They are monitored by a trained member of staff, such as a public health officer.

This paper shows how the Extending Service Delivery improve maternal and newborn health in Egypt’s Kaliobia Governorate by scaling-up the government’s postpartum care package in 13 villages, and training community health workers and nurses to put the package into practice. [from author]

This brief outlines the lessons learned from a 30 year village health improvement project in rural India that integrated community participation and established the value of village health workers.

This brief is a summary of the key messages from the Global Consultation on Community Health Workers in April 2010. It discusses planning, production and deployment; attraction and retention; and performance management as it relates to community health workers. [adapted from author]

Excitement is rapidly growing concerning the potential for community- based primary health care (CBPHC) to accelerate progress in reducing the tragedy of millions of children dying world-wide each year from readily preventable or treatable conditions. This report summarizes the current research findings concerning the effectiveness of CBPHC in improving the health of children in high-mortality, resource-poor settings. [from summary]

With the overall aim of identifying community health worker (CHW) programs with positive impact on Millennium Development Goals (MDGs) related to health or otherwise, this global systematic review was undertaken of such interventions, as well as eight in-depth country case studies in Sub-Saharan Africa (Ethiopia Mozambique and Uganda), South East Asia (Bangladesh, Pakistan and Thailand) and Latin America (Brazil and Haiti).

The objective of this literature review is to assess the effectiveness of community-based intervention packages of improved maternal care during pregnancy, delivery and postpartum, as well as care of the newborn, in preventing maternal morbidity and mortality and improving neonatal outcomes. [adapted from summary]

This study evaluates the health impacts of a volunteer intervention addressing health worker shortage in remote mountainous communities of Vietnam. [from abstract]

This paper investigates the role of various healthcare providers in provision of health services in a remote rural area in Bangladesh. [from abstract]

This study assessed community acceptability of the use of rapid diagnostic tests by Ugandan community health workers, locally referred to as community medicine distributors. [from abstract]

Although the community health service system is now established in China, the utilisation of the community health service institutions is low due to the lack of a gate-keeping role of the primary health service providers and referrals among the three-tiered health service institutions. This study focuses on the question of how to increase the utilisation of Chinese community health centres. [from abstract]

This article investigated the reasons for the high rates of community health worker attrition in Bangladesh. [adapted from abstract]

Ethiopia’s health extension workers (HEW) deliver preventive interventions and treat childhood diarrhea and malaria, but not pneumonia. Most of Ethiopia’s annual estimated 4 million childhood pneumonia cases go untreated. The purpose of this study was to evaluate the performance of volunteers in providing community case management for diarrhea, fever and pneumonia in a pre-HEW setting in Ethipia. [adapted from abstract]

This qualitative paper reports on the experience of three community health worker (CHW) supervisors who were responsible for supporting infant feeding peer counsellors. The findings highlight the complexities of supervising and supporting CHWs. [adapted from abstract]

Ensuring skilled attendant at birth is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assesses a community-based safe motherhood intervention in Mtwara rural District of Tanzania. [from abstract]

This report outlines a training program for health extension workers in long-acting family planning methods in Ethiopia.

Lay or community workers can be a valuable resource in response to the human resource crisis in many low- and middle-income countries. Successful interventions by lay health workers have led to improvements in maternal and child health, including reductions in mortality and morbidity from common childhood illnesses, and effective support to people receiving treatment for tuberculosis. [from author]

Improving neonatal health and survival requires cost-effective interventions at the community level, as well as linkages between the community and the health-care system within the continuum of care for the treatment of severe illness. The primary purpose of this study was to evaluate the performance of CHWs in recognizing signs and symptoms of neonatal illness during routine household surveillance in rural Bangladesh. [from introduction]

In 2008, Malawi piloted the distribution of depo-medroxy progesterone acetate (DMPA), an injectable contraceptive, to the community by Health Surveillance Assistants. This report presents lessons learned during the initial implementation, from gaining stakeholder buy-in to curriculum development, and the initial three months after the training and implementation roll-out. [from abstract]

In this study, we aimed to determine the cost and cost-effectiveness of involving health extension workers in tuberculosis treatment in Southern Ethiopia. This paper presents an ancillary cost-effectiveness analysis of data from a randomized control trial. [adapted from introduction]

The objective of this document was to conduct a systematic review of the evidence on characteristics of community health workers (CHWs) and CHW interventions, outcomes of such interventions, costs and cost-effectiveness of CHW interventions, and characteristics of CHW training. [from abstract]

The objective of this study was to assess the skills of community health volunteers in diagnosing active trachoma, the world’s leading cause of preventable blindness, and distributing azithromycin treatment in the Northern Region of Ghana. [adapted from author]

Thanks to a small cadre of village volunteers, trained in basic health-care concepts, western Uganda is beginning to see some promising improvements in child health. [from author]

In rural settings, the promotion of household and community health practices through community health workers (CHWs) is among the key strategies to improve child health. The objective of this study was to assess the performance of CHWs in the promotion of basic child health services in rural Mali. [from abstract]

This report presents research findings on the potential for making contraceptives, and in particular injectable contraceptives, widely available through using a community-based distribution approach which would expand the cadre of providers authorized to provide contraceptives to include health surveillance assistants and community-based distribution agents. [adapted from summary]

This paper reviews the costs and cost-effectiveness of vaccination programme interventions involving lay or community health workers. [from abstract]