scholarly journals Long-Term Impact of Single Epilepsy Training on Knowledge, Attitude and Practices: Comparison of Trained and Untrained Rwandan Community Health Workers

2021 ◽  
Vol 66 ◽  
Author(s):  
Peter Dedeken ◽  
Stephen N. Muhumuza ◽  
Fidele Sebera ◽  
Josiane Umwiringirwa ◽  
Leopold Bitunguhari ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Multivariate Analyses ◽  
Health Workers ◽  
Demographic Differences ◽  
Negative Attitudes ◽  
Related Stigma ◽  
Long Term Impact ◽  
The Impact

Objectives: To close the epilepsy treatment gap and reduce related stigma, eradication of misconceptions is importantIn 2014, Community Health Workers (CHWs) from Musanze (Northern Rwanda) were trained on different aspects of epilepsy. This study compared knowledge, attitude and practices (KAPs) towards epilepsy of trained CHWs 3 years after training, to untrained CHWs from Rwamagana (Eastern Rwanda).Methods: An epilepsy KAP questionnaire was administered to 96 trained and 103 untrained CHWs. Demographic and intergroup KAP differences were analysed by response frequencies. A multivariate analyses was performed based on desired and undesired response categories.Results: Epilepsy awareness was high in both groups, with better knowledge levels in trained CHWs. Negative attitudes were lowest in trained CHWs, yet 17% still reported misconceptions. Multivariate analysis demonstrated the impact of the training, irrespective of age, gender and educational level. Knowing someone with epilepsy significantly induced more desired attitudes.Conclusion: Despite demographic differences between trained and untrained CHWs, a single epilepsy training resulted in significant improvement of desired KAPs after 3 years. Nation-wide CHW training programs with focus on training-resistant items, e.g., attitudes, are recommended.

scholarly journals Connecting communities to primary care: a qualitative study on the roles, motivations and lived experiences of community health workers in the Philippines

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eunice Mallari ◽  
Gideon Lasco ◽  
Don Jervis Sayman ◽  
Arianna Maever L. Amit ◽  
Dina Balabanova ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Health ◽  
Community Health Workers ◽  
Financial Incentives ◽  
Lived Experiences ◽  
Health Workers ◽  
The Philippines ◽  
Community Members ◽  
Cross Sectional ◽  
The Impact

Abstract Background Community health workers (CHWs) are an important cadre of the primary health care (PHC) workforce in many low- and middle-income countries (LMICs). The Philippines was an early adopter of the CHW model for the delivery of PHC, launching the Barangay (village) Health Worker (BHW) programme in the early 1980s, yet little is known about the factors that motivate and sustain BHWs’ largely voluntary involvement. This study aims to address this gap by examining the lived experiences and roles of BHWs in urban and rural sites in the Philippines. Methods This cross-sectional qualitative study draws on 23 semi-structured interviews held with BHWs from barangays in Valenzuela City (urban) and Quezon province (rural). A mixed inductive/ deductive approach was taken to generate themes, which were interpreted according to a theoretical framework of community mobilisation to understand how characteristics of the social context in which the BHW programme operates act as facilitators or barriers for community members to volunteer as BHWs. Results Interviewees identified a range of motivating factors to seek and sustain their BHW roles, including a variety of financial and non-financial incentives, gaining technical knowledge and skill, improving the health and wellbeing of community members, and increasing one’s social position. Furthermore, ensuring BHWs have adequate support and resources (e.g. allowances, medicine stocks) to execute their duties, and can contribute to decisions on their role in delivering community health services could increase both community participation and the overall impact of the BHW programme. Conclusions These findings underscore the importance of the symbolic, material and relational factors that influence community members to participate in CHW programmes. The lessons drawn could help to improve the impact and sustainability of similar programmes in other parts of the Philippines and that are currently being developed or strengthened in other LMICs.

Supervising Community Health Workers in Community-Based Delivery of Primary Health/Family Planning Services: Experiences in Mexico, 1977–1982

1986 ◽  
Vol 6 (4) ◽  
pp. 309-322 ◽  
Author(s):  
Michele G. Shedlin ◽  
Joe D. Wray ◽  
Sergio Correu
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Program ◽  
Health Workers ◽  
Community Based ◽  
Family Planning Services ◽  
Roles And Responsibilities ◽  
Primary Health ◽  
Wide Range

The supervision of CHWs in the Mexican Rural Health Program (1977–82) illustrates a wide range of problems and strengths because it was developed within a program based on a strong political mandate to deliver services to an extremely large, as well as culturally and geographically diverse population. This article presents an in-depth perspective on the issues involved in the supervision of community health workers with a focus on the myriad roles and responsibilities which are expected from supervisory personnel. The information and observations which are offered come from program evaluation materials as well as the long-term, first hand experience of the authors with the program discussed.

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’s social networks; and harnessing community health workers’ social role. Practical demonstration, opportunity to participate and convenience of making of the plate with the food available in their kitchen or neighbours’ 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 Reactions of community members regarding community health workers’ activities as a measure of the impact of a training program in Amazonas, Brazil

2015 ◽  
Vol 10 (1) ◽  
pp. 7-19 ◽  
Author(s):  
Ryoko Kawasaki ◽  
Toru Sadamori ◽  
Terezinha Ferreira de Almeida ◽  
Megumi Akiyoshi ◽  
Mika Nishihara ◽  
...  
Keyword(s):  
Community Health ◽  
Training Program ◽  
Community Health Workers ◽  
Health Workers ◽  
Community Members ◽  
The Impact

scholarly journals The roles, training and knowledge of community health workers about diabetes and hypertension in Khayelitsha, Cape Town

Curationis ◽  
2018 ◽  
Vol 41 (1) ◽  
Author(s):  
Lungiswa P. Tsolekile ◽  
Helen Schneider ◽  
Thandi Puoane
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Multivariate Analyses ◽  
Health Workers ◽  
Cross Sectional Study ◽  
Basic Knowledge ◽  
Cross Sectional ◽  
Secondary Schooling ◽  
Service Support ◽  
And Control

Background: The current roles and capacity of community health workers (CHWs) in the management and control of non-communicable diseases (NCDs) remain poorly understood.Objectives: To assess CHWs’ current roles, training and knowledge about diabetes and hypertension in Khayelitsha, Cape Town.Methods: A cross-sectional study of 150 CHWs from two non-governmental organisations contracted to provide NCD care as part of a comprehensive package of services was conducted. An interviewer-administered closed-ended questionnaire was used to determine the roles, training, in-service support, knowledge and presence of NCDs. Descriptive analyses of these domains and multivariate analyses of the factors associated with CHWs’ knowledge of hypertension and diabetes were conducted.Results: The vast majority (96%) of CHWs were female, with a mean age of 35 years; 88% had some secondary schooling and 53% had been employed as CHWs for 4 years or more. Nearly half (47%) reported having an NCD. CHWs’ roles in NCDs included the delivery of medication, providing advice and physical assessment. Only 52% of CHWs reported some formal NCD-related training, while less than half of the trained CHWs (n = 35; 44%) had received follow-up refresher training. CHWs’ knowledge of diabetes and hypertension was poor. In the multivariate analyses, higher knowledge scores were associated with having an NCD and frequency of supervisory contact (≥1 per month).Conclusions: The roles performed by CHWs are broad, varied and essential for diabetes and hypertension management. However, basic knowledge about diabetes and hypertension remains poor while training is unstandardised and haphazard. These need to be improved if community-based NCD management is to be successful. The potential of peer education as a complementary mechanism to formal training needs as well as support and supervision in the workplace requires further exploration.

scholarly journals Building on facilitators and overcoming barriers to implement active tuberculosis case-finding in Nepal, experiences of community health workers and people with tuberculosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Olivia Biermann ◽  
Kritika Dixit ◽  
Bhola Rai ◽  
Maxine Caws ◽  
Knut Lönnroth ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Social Determinants ◽  
Organizational Context ◽  
Health Workers ◽  
Case Finding ◽  
World Health ◽  
The Social ◽  
Facilitators And Barriers ◽  
The Impact

Abstract Background Nepal has a high burden of undetected tuberculosis (TB). In line with the World Health Organization’s End TB Strategy, the National TB Programme promotes active case-finding (ACF) as one strategy to find people with TB who are unreached by existing health services. The IMPACT TB (Implementing proven community-based active TB case-finding intervention) project was implemented in four districts in Nepal, generating a substantial yield of previously undetected TB. We aimed to identify the facilitators and barriers linked to the implementation of ACF within IMPACT TB, as well as how those facilitators and barriers have been or could be addressed. Methods This was an exploratory qualitative study based on 17 semi-structured key-informant interviews with people with TB who were identified through ACF, and community health workers who had implemented ACF. Thematic analysis was applied in NVivo 11, using an implementation science framework developed by Grol and Wensing to classify the data. Results We generated five main themes from the data: (1) ACF addressed the social determinants of TB by providing timely access to free healthcare, (2) knowledge and awareness about TB among people with TB, communities and community health workers were the ‘oil’ in the ACF ‘machine’, (3) trust in community health workers was fundamental for implementing ACF, (4) community engagement and support had a powerful influence on ACF implementation and (5) improved working conditions and enhanced collaboration with key stakeholders could further facilitate ACF. These themes covered a variety of facilitators and barriers, which we divided into 22 categories cutting across five framework levels: innovation, individual professional, patient, social context and organizational context. Conclusions This study provides new insights into facilitators and barriers for the implementation of ACF in Nepal and emphasizes the importance of addressing the social determinants of TB. The main themes reflect key ingredients which are required for successful ACF implementation, while the absence of these factors may convert them from facilitators into barriers for ACF. As this study outlined “how-to” strategies for ACF implementation, the findings can furthermore inform the planning and implementation of ACF in Nepal and similar contexts in low- and middle-income countries.

scholarly journals HIV- and Drug Use–Related Stigma and Service Provision Among Community Health Workers in Vietnam

2020 ◽  
Vol 32 (2) ◽  
pp. 169-179
Author(s):  
Li Li ◽  
Chunqing Lin ◽  
Li-Jung Liang ◽  
Jun Chen ◽  
Nan Feng ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Service Provision ◽  
Health Workers ◽  
People Who Use Drugs ◽  
People Living With Hiv ◽  
Related Services ◽  
Related Stigma ◽  
Living With Hiv ◽  
The Relationship

This study compared community health workers' (CHW) stigma towards people living with HIV (PLH) and people who use drugs (PWUD) and explored the relationship between stigma and CHWs' confidence level in providing HIV/drug-related services. Using two sets of identically worded questions, levels of stigma towards PWUD and PLH were measured among 120 CHW from 60 communes in Vietnam. The associations between CHWs' confidence in service provision and stigma towards PWUD and PLH were examined using a linear mixed-effects regression model. The majority of the CHW reported higher levels of stigma towards PWUD than towards PLH. Compared to the CHW reporting higher stigma towards PWUD, those with higher stigma towards PLH were significantly less confident in service provision. Social opprobrium attached to drug-using behaviors can be a major driver behind the overall HIV stigma. CHWs' fear of HIV infection should be tackled to boost their confidence in HIV/drug-related care provision.

scholarly journals The Impact of Integrating Community Health Workers Into the Patient-Centered Medical Home

2014 ◽  
Vol 5 (4) ◽  
pp. 271-274 ◽  
Author(s):  
Luz Adriana Matiz ◽  
Patricia J. Peretz ◽  
Patricia G. Jacotin ◽  
Carmen Cruz ◽  
Erline Ramirez-Diaz ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Medical Home ◽  
Health Workers ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
The Impact
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