Community Interventions

Provider Payment in Community-Based Health Insurance Schemes in Developing Countries: A Systematic Review

The authors reviewed provider payment methods used in community-based insurance (CBI) in developing countries and their impact on CBI performance. [from abstract]

Systematic Review of Strategies to Increase Demand, Uptake and Quality of Community-Based Diagnosis and Case Management of Malaria

This review assessed evidence on community-based diagnosis and care of malaria including investigation of interventions to improve the quality of services provided by community health workers (CHWs); strengthen referrals by CHWs to facility-based providers; build the capacity of health systems to support community case management; and integrate malaria diagnosis and case management with other health services at the community level. [adapted from summary]

Model for Community Health Service Development in Depressed Rural Areas in China

This article describes and intervention to introduce a model of community health service organization, as implemented in urban areas, to less developed rural areas in China and evaluate the impact of this model on health care utilization. [adapted from abstract]

How to Keep ART Patients in Long-Term Care: ART Adherence Club Report and Toolkit

This toolkit is simple model that allows patient groups to collect pre-packed, two-month supplies of treatment from lay health workers either at the clinic or outside of the clinic - whether at a local library or at a fellow patients home. Antiretroviral treatment (ART) adherence clubs give stable adherent HIV patients easier access to their treatment, while unclogging clinics and freeing up scarce nurses and doctors to manage new or at-risk HIV patients. [from publisher]

Where There is No Paramedic: The Sachigo Lake Wilderness Emergency Response Education Initiative

This paper reports on a collaboration to develop, deliver, and study a community-based first response training program in a remote indigenous community. [from author]

Client Characteristics and Acceptability of a Home-Based HIV Counselling and Testing Intervention in Rural South Africa

There is growing interest in expanding testing coverage through the implementation of innovative models such as home-based HIV counselling and testing (HBHCT) by trained lay counsellors. With the aim of informing scale up, this paper discusses client characteristics and acceptability of an HBHCT intervention implemented in rural South Africa. [from abstract]

Primary Health Care in Rural Malawi: A Qualitative Assessment Exploring the Relevance of the Community-Directed Interventions Approach

Community-directed treatment with ivermectin (CDTi) and community-directed interventions (CDI) are participatory approaches to strengthen health care at community level. This study aimed at assessing primary health care in two rural Malawian districts without CDTi experience with a view to explore the relevance of the CDI approach. [adapted from abstract]

Community-Based Monitoring Programs in the Health Sector: A Literature Review

The purpose of this paper is to survey the literature on community monitoring projects that have attempted to improve health sector governance by promoting greater community involvement in monitoring and oversight of health service providers, to describe common features and shared challenges that these projects face, to identify existing gaps in knowledge and practice, and serve as an input to a broader discussion of the prospects for incorporation of community-based accountability mechanisms in performance-based incentive programs. [adapted from introduction]

Early Detection of Tuberculosis through Community-Based Active Case Finding in Cambodia

This paper examines the differences in the demographic characteristics, smear grades, and treatment outcomes of pulmonary tuberculosis cases detected through both active and passive case finding to determine if active case finding from health workers in mobile radiography units could contribute to early case finding, considering associated project costs. [adapted from author]

Community Health and Development (CHAD) Christian Medical College, Vellore

This case study highlights the efficiency with which the Community Health and Development (CHAD) program of the Christian Medical College, Vellore has obtained results through a combination of community-based provider training and innovative community service delivery methodologies, as well as discuss how aspects of the model can be adopted by other institutions to achieve similar results. [adapted from author]

Kollyani: A Community Led Health Care Program at Tribal Villages of Bandarban District, Bangladesh

This case study has studied the service delivery model of Kollyani, worked with the remote villages of the Bandarban district to create primary health centers where previously the area had none. Utilizing the local people and resources, they were able to create six local clinics run by trained villagers. The study examines the inputs invested and the outcomes produced in terms of health and social development and the issue of sustainability. [adapted from publisher]

Development of a Lay Health Worker Delivered Collaborative Community Based Intervention for People with Schizophrenia in India

This paper describes a systematically developed intervention for a lay health worker delivered, community-based intervention for schizophrenia care in three sites in India. [adapted from abstract]

Community Engagement in Facility-Based Quality Improvement in the Philippines: Lessons for Service Delivery and Governance

This report summarizes a quality assurance project and explains how citizens were engaged at the facility level in improving health service quality, while also contributing to increased responsiveness and accountability on the part of health providers. [adapted from author]

Promoting Health Lifestyles: Community Health Workers' Intervention Programme for Primary Prevention of Non-Communicable Diseases in Khayelitsha, an Urban Township in Cape Town

A community-based project to increase community awareness about primary prevention of non-communicable diseases (NCDs) was implemented in an urban township of Cape Town. The aims of project were to utilise community health workers as change agents in their community and to develop a NCD model for an urban township community. [adapted from author]

Building on the Current Evidence to Strengthen Community-Based Service Delivery Strategies for Promoting Child Survival

This document highlights four community-based health delivery strategies that have demonstrated improvements in child health in high-mortality, low-resource settings and supports the growing recognition that community programs that reach beyond the walls of health care facilities and involve community members as partners have a great potential for further reducing child mortality at low cost. [adapated from author]

Treating Childhood Pneumonia in Hard-to-Reach Areas: A Model-Based Comparison on Mobile Clinics and Community-Based Care

This paper uses a decision mathematical model to estimate the relative effectiveness of two alternative strategies, mobile clinics and fixed community-based health services, for antibiotic treatment of childhood pneumonia, the world’s leading cause of child mortality. [from abstract]

Evidence in Support of Community Based Interventions: Implications for Maternal, Newborn and Child Health

This presentation covers: global trends for maternal and childe survival; determinants of MDGs; current knowledge on what works and the role of human resources for health; and the role of innovations in scaling up. [adapted from author]

Evaluation of a Community-Based Rehabilitation Model for Chronic Schizophrenia in Rural India

Community-based rehabilitation (CBR) is a model of care which has been widely used for physical disabilities in resource-poor settings. This study aimed to compare CBR with out-patient care (OPC) for schizophrenia in a resource-poor setting in India to determine if it is a feasible model for treatment in areas without specialized mental health care providers. [adapted from author]

Community Participation in Rural Primary Health Care: Intervention or Approach?

This literature review focused on evidence of the effectiveness of community participation and its role in rural primary health care service design and delivery to increase the likelihood of genuine community-health sector partnerships and more responsive health services for rural communities.

Preventing Postpartum Hemorrhage: Community-Based Distribution of Misoprostol in Tangail District, Bangladesh

This brief outlines a project whose objective was to have health and family planning field workers from the government and from nongovernmental organizations distribute misoprostol tablets to pregnant women in Tangail District in central Bangladesh, to assess the approach’s effectiveness, and to gather lessons learned and provide recommendations for national scale-up. [adapted from author]

Implementing Knowledge into Practice for Improved Neonatal Survival: a Cluster-Randomised, Community-Based Trial in Quang Ninh Province, Vietnam

The overall objective of this study was to evaluate if a facilitation intervention on the community level, with a problem-solving approach involving local representatives if the healthcare system and the community, results in improvements of neonatal health and survival. [adapted from abstract]

Health Facility Committees and Facility Management: Exploring the Nature and Depth of Their Roles in Coast Province, Kenya

This article explores the nature and depth of managerial engagement of health facility committees at the facility level in two rural districts in Kenya, and how this has contributed to community accountability. [from abstract]

Effectiveness of a Community Intervention on Malaria in Rural Tanzania: a Randomised Controlled Trial

This article describes a community intervention conducted aimed at improving early malaria case management in under five children. Health workers were trained to train community-based women groups in recognizing malaria symptoms, providing first-line treatment for uncomplicated malaria and referring severe cases. [adapted from abstract]

Ethiopia’s Health Extension Program: Improving Health through Community Involvement

This article discusses the Health Extension Program, an innovative community-based health program in Ethiopia. It is based on the assumption that access to and quality of primary health care in rural communities can be improved through transfer of health knowledge and skills to households.

Training Family Physicians in Community Health Centers: A Health Workforce Solution

For more than 25 years, family medicine residencies have worked with community health centers (CHCs) to train family physicians. This study compares CHC and non-CHC-trained family physicians regarding practice location, job and training satisfaction, and recruitment and retention to underserved areas. [from author]

Evaluation of a Community-Based Randomized Controlled Prenatal Care Trial in Rural China

The purpose of this paper is to describe implementation and impact of a community-based prenatal care trial on the utilization of prenatal care and perinatal outcomes in China. [adapted from abstract]

Toolkit: Community Empowerment in MNH Towards the Alert Village (Desa Siaga)

The toolkit describes a process of implementing community empowerment in maternal and neonate health (MNH) and each step of the process, including guidelines and training manuals for the implementation process. The aim of this toolkit is to provide an example of possible best practice in community mobilisation to compliment medical based initiatives to reduce maternal death. [adapted from author]

Desa Siaga Cost Analysis

The term “Desa Siaga” describes the concept of community members owning their own resources and capacities for preventing and overcoming their own health problems, health emergencies and disasters based on mutual support and in a spirit of togetherness. This cost analysis provides additional information for all stakeholders contributing to informed decision making regarding DS implementation and this from an economic perspective. [from executive summary]

Reducing the Burden of Maternal Mortality in Afghanistan: Merlin's Community Midwifery Education Programme in Takhar

The purpose of this paper is to provide an overview of an Afghanistan community midwifery program in Takhar Province, to capture key lessons learnt from the first round of training, and to draw conclusions for future initiatives. [adapted from author]

Sustaining Community-Based Health Initiatives

This report evaluates what kind of health care and health education were still being promoted five years after the Kisumu Primary Health Care project had ended, and what had happened to all the voluntary health workers that had been trained as part of the project’s focus on community health workers and community involvement in service delivery. [adapted from author]