Community health volunteers could help improve access to and use of essential health services by communities in LMICs: an umbrella review.
Mirkuzie Woldie,Mirkuzie Woldie,Garumma Tolu Feyissa,Bitiya Admasu,Kalkidan Hassen,Kirstin R Mitchell,Susannah H. Mayhew,Martin McKee,Dina Balabanova +8 more
TLDR
An umbrella review of systematic reviews found that services provided by CHVs were not inferior to those provided by other health workers, and sometimes better, however, CHVs performed less well in more complex tasks such as diagnosis and counselling.Abstract:
A number of primary studies and systematic reviews focused on the contribution of community health workers (CHWs) in the delivery of essential health services. In many countries, a cadre of informal health workers also provide services on a volunteer basis [community health volunteers (CHV)], but there has been no synthesis of studies investigating their role and potential contribution across a range of health conditions; most existing studies are narrowly focused on a single condition. As this cadre grows in importance, there is a need to examine the evidence on whether and how CHVs can improve access to and use of essential health services in low- and middle-income countries (LMICs). We report an umbrella review of systematic reviews, searching PubMed, the Cochrane library, the database of abstracts of reviews of effects (DARE), EMBASE, ProQuest dissertation and theses, the Campbell library and DOPHER. We considered a review as 'systematic' if it had an explicit search strategy with qualitative or quantitative summaries of data. We used the Joanna Briggs Institute (JBI) critical appraisal assessment checklist to assess methodological quality. A data extraction format prepared a priori was used to extract data. Findings were synthesized narratively. Of 422 records initially found by the search strategy, we identified 39 systematic reviews eligible for inclusion. Most concluded that services provided by CHVs were not inferior to those provided by other health workers, and sometimes better. However, CHVs performed less well in more complex tasks such as diagnosis and counselling. Their performance could be strengthened by regular supportive supervision, in-service training and adequate logistical support, as well as a high level of community ownership. The use of CHVs in the delivery of selected health services for population groups with limited access, particularly in LMICs, appears promising. However, success requires careful implementation, strong policy backing and continual support by their managers.read more
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The best person (or machine) for the job: Rethinking task shifting in healthcare.
May C I van Schalkwyk,Aleš Bourek,Dionne S. Kringos,Luigi Siciliani,Margaret M. Barry,Jan De Maeseneer,Martin McKee +6 more
TL;DR: A position paper is presented based on the work and expertise of the European Commission Expert Panel on Effective ways of Investing in Health that contends that this is over simplistic, and aims to provide a new task shifting framework, informed by relevant evidence, and a series of recommendations.
Journal ArticleDOI
Lay‐led and peer support interventions for adolescents with asthma
TL;DR: Weak evidence suggests that lay-led and peer support interventions for adolescents with asthma could lead to a small improvement in asthma-related quality of life for adolescents, but benefits for asthma control, exacerbations and medication adherence remain unproven.
Journal ArticleDOI
The Effects of Community Home Visit and Peer Group Nutrition Intervention Delivery Platforms on Nutrition Outcomes in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis
TL;DR: Meta-analysed outcomes for community health worker (CHW) home visits and mother/peer group delivery platforms underscore the importance of interpersonal community platforms for improving infant and young child feeding practices and children’s nutritional status in LMICs.
Journal ArticleDOI
After the Astana declaration: is comprehensive primary health care set for success this time?
Christian Kraef,Per Kallestrup +1 more
TL;DR: This analysis examines the challenges that comprehensive PHC faced after the Alma-Ata declaration, provides an analysis of the current opportunities and threats and reviews the most important policy recommendations and related evidence to address these threats for success of the Astana declaration.
Journal ArticleDOI
Improving the quality of maternal and newborn care in the Pacific region: A scoping review
Alyce N. Wilson,Alyce N. Wilson,N. Spotswood,N. Spotswood,N. Spotswood,G.S. Hayman,Joshua P. Vogel,Joshua P. Vogel,J. Narasia,Arthur Elijah,Christopher Morgan,Christopher Morgan,Alison Morgan,James G. Beeson,James G. Beeson,Caroline S.E. Homer,Caroline S.E. Homer +16 more
TL;DR: To effectively strengthen quality maternal and newborn care in this region, efforts must broaden to improve health system leadership, deliver sustaining education programs and encompass learnings from women and their communities.
References
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TL;DR: The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016 as discussed by the authors, which includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends.