Community Interventions

Cost-Effectiveness of Facility and Home Based HIV Voluntary Counseling and Testing Strategies in Rural Uganda

This article evaluates the cost effectiveness of facility-and home-based voluntary counseling and testing (VCT) utilizing community health workers with the primary outcome measure of extra cost per HIV sero-positive case identified to help for health service managers at primary care level in making decisions on suitable alternatives for VCT provision in rural communities in Uganda based on operational efficiency. [adapted from author]

Review of Generalist and Specialist Community Health Workers for Delivering Adolescent Health Services in Sub-Saharan Africa

This paper reviews the literature on generalist and specialist community health workers to assess their potential for strengthening the delivery of adolescent health services. [from abstract]

Roles and Effectiveness of Lay Community Health Workers in the Prevention of Mental, Neurological and Substance Use Disorders in Low and Middle Income Countries: A Systematic Review

This article summarizes a systematic literature review that aimed to assess the existing evidence base for the roles and effectiveness of lay community health workers in primary and secondary prevention of mental, neurological and substance us disorders in low and middle income countries. [adapted from abstract]

Community Caregivers: The Backbone for Accessible Care and Support

This report is the result of research undertaken in South Africa to review community and home-based care, especially in regards to HIV prevention, treatment, care and support. The research highlights the important roles played by caregivers in health promotion programs, counselling and testing, client advocacy, stigma mitigation and community mobilization. [adapted from author]

House Calls by Community Health Workers and Public Health Nurses to Improve Adherence to Isoniazid Montotherapy for Latent Tuberculosis Infection: A Retrospective Study

The goal of this study was to assess whether house calls by community health workers and public health nurses affected isoniazid adherence for latent tuberculosis infection or frequency of adverse effects. [adapted from author]

Sources of Community Health Worker Motivation: A Qualitative Study in Morogoro Region, Tanzania

This study aimed to explore sources of community health worker motivation to inform programs in Tanzania and similar contexts. [from abstract]

Insights from Community Case Management Data in Six Sub-Saharan African Countries

This study analyzed monitoring data from community case management (CCM) programs supported by the International Rescue Committee, covering over 2 million treatments provided from 2004 to 2011 in six countries by 12,181 community health workers to generate evidence on how to implement CCM. [adapted from abstract]

Comparison of Methods for Assessing Quality of Care for Community Case Management of Sick Children: An Application with Community Health Workers in Malawi

As part of an assessment of quality of community case management services in Malawi, this report examines the bias associated with measuring community health worker performance by using register review, case scenarios, and direct observation only methods compared with direct observation with re-examination by a higher-level clinician, and discusses the relative strengths and weaknesses of the four assessment methods in the Malawi context. [adapted from author]

Interventions to Improve Motivation and Retention of Community Health Workers Delivering Integrated Community Case Management (iCCM): Stakeholder Perceptions and Priorities

This work reports the results of semi-structured interviews with 15 international stakeholders, selected because of their experiences in community health worker program implementation, to elicit their views on strategies that could increase community health worker motivation and retention. [from abstract]

Community Health Workers Providing Government Community Case Management for Child Survival in Sub-Saharan Africa: Who Are They and What Are They Expected to Do?

This article describes community health workers in government community case management programs for child survival across sub-Saharan Africa. [from abstract]

Health Workers' and Managers' Perceptions of the Integrated Community Case Management Program for Childhood Illness in Malawi: The Importance of Expanding Access to Child Health Services

Community case management (CCM) is a promising task-shifting strategy for expanding treatment of childhood illness that is increasingly adopted by low-income countries. This study uses qualitative methods to explore health workers’ and managers’ perceptions about CCM provided by health surveillance assistants during the program’s first year in Malawi. [adapted from abstract]

Scaling Up Integrated Community Case Management of Childhood Illness: Update from Malawi

This paper documents progress in the scale up of a program to train an existing cadre of community based health workers, known as health surveillance assistants, to provide integrated community case management of childhood illness between 2008 and 2011. It describes some critical challenges that affect the effectiveness and sustainability of the program, and proposes solutions. [adapted from introduction]

Introduction of Newborn Care within Integrated Community Case Management in Uganda

This article assessed how a program for integrated community case management (iCCM) for children under 5 years addresses newborn care in three mid-western districts through document reviews, structured interviews, and focus group discussions with village health team members trained in iCCM, caregivers, and other stakeholders. [adapted from abstract]

Increased Use of Community Medicine Distributors and Rational Use of Drugs in Children Less than Five Years of Age in Uganda Caused by Integrated Community Case Management of Fever

This study compared effectiveness and use of community medicine distributors and drug use under integrated community case management and home-based management strategies in children 6–59 months of age in eastern Uganda. [adapted from abstract]

Use of Community Health Workers for Management of Malaria and Pneumonia in Urban and Rural Areas in Eastern Uganda

This study assessed the potential differences between urban and rural areas in the implementation of community case management is implemented for malaria and pneumonia and how community health workers are being used alongside other partners in health care provision. [adapted from introduction]

Why We Must Provide Better Support for Pakistan's Female Frontline Health Workers

This article summarizes the key role that lady health workers play in polio eradication; outlines the problems faced by these workers such as the risk to their lives through shootings and bombings, the lack of a living wage and dearth of advancement opportunities; and offers suggestions to improve the situation.

Effectiveness of Community Health Workers Delivering Preventive Interventions for Maternal and Child Health in Low- and Middle-Income Countries: A Systematic Review

This review reports findings on a systematic review analyzing the effectiveness of preventive interventions delivered by community health workers for maternal and child health in low- and middle-income countries. [from abstract]

Strong Effects of Home-Based Voluntary HIV Counseling and Testing on Acceptance and Equity: A Cluster Randomized Trial in Zambia

This study investigated the acceptance of home-based counselling and testing by lay counselors, its equity in uptake and the effect of negative life events with a cluster-randomized trial. [adapted from abstract]

Role of Social Geography on Lady Health Workers' Mobility and Effectiveness in Pakistan

This study explores whether and how socio-cultural factors such as influence of gendered norms and extended family relationships impact lady health workers’ home-visit rates. [adapted from abstract]

Mozambique: Strengthening the Community Health Worker Supply Chain Preliminary Report

This report is an interim summary of ongoing supply chain strengthening interventions focused on community health workers in Mozambique. The piloting of these interventions aims to improve the performance of the supply chain that provides these community health workers with antimalarial drugs, rapid diagnostic tests, male condoms, and essential medicines for a variety of treatments. [from summary]

Community-Based Care for Drug-Resistant Tuberculosis: A Guide for Implementers

Effectively scaling up treatment of drug-resistant tuberculosis (DR TB) will require addressing health systems–related issues, such as task shifting to alleviate human resources shortages and greater community engagement. This guide provides practical, step-by-step guidance on how to organize, implement, and monitor community-based care for DR TB. [adapted from introduction]

Community Health Workers Evidence-Based Models Toolbox

The intent of this report was to conduct extensive literature reviews on community health worker models that have been proven to work and then share those strategies with rural communities so that they do not have to reinvent the wheel. [from introduction]

One Million Community Health Workers in Sub-Saharan Africa by 2015

This article discusses the emergence of community health workers as a focal point of international discussions of primary health care systems and the way that community health worker programs have changed accordingly. [adapted from author]

Role of Community-Based Health Planning and Services Strategy in Involving Males in the Provision of Family Planning Services: A Qualitative Study in Southern Ghana

This study evaluated the effect of a program that trained community health nurses and relocated them to the community to provide door-to-door services on the level of male involvement in family planning services. [adapted from author]

Human Resource Development for a Community-Based Health Extension Program: A Case Study from Ethiopia

This article describes the strategies, human resource developments, service delivery modalities, progress in service coverage, and the challenges in the implementation of the Health Extension Program, a a primary care delivery strategy, to address the challenges and achieve the World Health Organization Millennium Development Goals within a context of limited resources in Ethiopia. [adapted from abstract]

Operations Research to Add Postpartum Family Planning to Maternal and Neonatal Health to Improve Birth Spacing in Sylhet District, Bangladesh

This article documents the intervention package and evaluation design of a study conducted in a rural district of Bangladesh to evaluate the effects of an integrated, community-based maternal and neonatal health and postpartum family planning program on contraceptive use and birth-interval lengths.

Reaching Mothers and Babies with Early Postnatal Home Visits: The Implementation Realities of Achieving High Coverage in Large-Scale Programs

Community-based maternal and newborn care programs with postnatal home visits from providers who can deliver preventive or curative services that save lives have been tested in Bangladesh, Malawi, and Nepal. This paper examines coverage and content of home visits in pilot areas and factors associated with receipt of postnatal visits. [adapted from abstract]

Training of Health Extension Workers on Family Folder and HMIS Procedures: Facilitators' Guide

This guidance document is for use principally by the district experts, heath extension supervisors and health extension workers all over the country as training on the health information systems requirements for local (community level) data collection, processing, analysis and dissemination, as well as linking to the national health management and information systems. [adapted from publisher]

Community Health Information System for Family-Centered Health Care: Scale-Up in Southern Nations, Nationalities and People's Region

This article describes the scale-up of the Community Health Information System (CHIS), a family-centered health information system designed for the health extension worker to manage and monitor her work in educating households and delivering an integrated package of promotive, preventive, and basic curative health service to families. It also documents achievements and challenges, sharing lessons learned that can be useful in CHIS implementation in other regions. [adapted from summary]

Quality of Sick Child Care Delivered by Health Surveillance Assistants in Malawi

This study was carried out to assess the quality of care provided by Health Surveillance Assistants—a cadre of community-based health workers—as part of a national scale-up of community case management of childhood illness in Malawi. [from abstract]