Community Interventions

Beyond Prevention: Home Management of Malaria in Kenya

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.

Lessons Learned from a Community-Based Health Care Project

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.

How Effective is Community-Based Primary Health Care in Improving the Health of Children? A Review of the Evidence

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]

Community-Based Intervention Packages for Preventing Maternal Morbidity and Mortality and Improving Neonatal Outcomes

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]

Analysis of Factors Influencing the Outpatient Workload at Chinese Health Centers

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]

Effectiveness of Community Based Safe Motherhood Promoters in Improving the Utilization of Obstetric Care: the Case of Mtwara Rural District in Tanzania

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]

Pilot Study of the Use of Community Volunteers to Distribute Azithromycin for Trachoma Control in Ghana

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]

Uganda Registers Successes with Child-Health Volunteers

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]

Evaluating the Impact of Community Based Health Interventions: Evidence from Brazil's Family Health Program

The goal of this paper is twofold. It uses the recent experience of Brazil’s Family Health Program to assess the effectiveness of community based health interventions as instruments for improvements in health conditions in less developed areas. It also evaluates whether the health improvements associated with the program also brought about the changes in household behavior predicted by economic theory and noticed in other contexts. [adapted from author]

Community-Based Care of Stroke Patients in a Rural African Setting

This article describes an attempt at developing a community-based model of stroke care based on the discharge planning of stroke patients, available resources and continuity of care between hospital and community in a remote rural setting in South Africa. [adapted from introduction]

Community Defined Quality (CDQ): Creating Partnerships for Improving Quality

This presentation outlines a methodology to improve quality and accessibility of health care with greater involvement of the community in defining, implementing and monitoring the quality improvement process.

Systematic Review of Effect of Community-Level Interventions to Reduce Maternal Mortality

The objective was to provide a systematic review of the effectiveness of community-level interventions to reduce maternal mortality. Selection criteria were maternity or childbearing age women, comparative study designs with concurrent controls, community-level interventions and maternal death as an outcome. [from abstract]

Perceptions of Short-Term Medical Volunteer Work: a Qualitative Study in Guatemala

The issue of participation by medical providers from wealthy countries in short-term medical volunteer work in resource-poor countries has been reaised as being potentially harmful to recipient communities. This exploratory study examines the perception of short-term medical volunteer work in Guatemala from the perspective of members of recipient communities affected by or participating in these programs. [adapted from sbstract]

Implementing a Community-Based Tuberculosis Program in the Omaheke Region of Namibia: Nurses' Perceived Challenges

The purpose of this survey was to identify nurses' perceived challenges in implementing a community-based TB program in the Omaheke region of Namibia. The HIV pandemic has increased the number of TB patients and increased nurses' workloads, aggravating the burden of TB as a resurgent disease in this region. In order to implement a successful community-based TB program, the patient-related, access-related and knowledge-related challenges, perceived by the nurses, need to be addressed effectively. [from abstract]

Community-Based Newborn Care: Are We There Yet?

The evidence base for strategies and interventions for newborn care in community settings has substantially improved, with a range of interventions that can be potentially packaged for delivery at different times during pregnancy, childbirth, and after birth, through various health-care providers. More recently, efficacy trials in representative rural settings have added to the evidence base. Such studies used innovative approaches with community health workers and varied preventive and treatment interventions. [from author]

Guidelines for Practitioners of Community-Based Worker Systems

The purpose of these guidelines is to assist practitioners and implementing partners to run Community-Based Worker (CBW) systems more effectively, maximising impacts for clients of the service, empowering communities, empowering the CBWs themselves, and assisting governments to ensure that services are provided at scale to enhance livelihoods. The guidelines focus on how to run the CBW system rather than technicalities around HIV/AIDS or natural resources issues. [from introduction]

Fewer Doctors and More Community Involvement to Scale Up Antiretroviral Treatment

The researchers conclude that given the HRH crisis, ART delivery models requiring much less doctor time need to be developed. Overall, there is a need to shift tasks from medical doctors to nurses and from nurses to community health workers. In particular, the patients themselves need to play an important role in the delivery of ART. The outcomes of the various scenarios are predicted. [from author]

Provision of Injectable Contraception Services through Community-Based Distribution: Implementation Handbook

Produced in collaboration with Save the Children USA, this step-by-step guide explains how to introduce injectable contraceptives

Mapping of Community Based Distribution Programs in Uganda

The mapping exercise illustrated in this report was conducted to inform and support the efforts of the Ugandan Ministry of Health to increase the contraceptive prevalence through enhanced community-based distribution (CBD) of family planning. The specific objectives of the exercise were to determine the historical and current coverage of CBD of family planning services in Uganda, by both governmental and nongovernmental programs, and to identify potential districts for scaling up these services. [adapted from summary]

Community-Based HIV/AIDS Prevention Care and Support Project (COPHIA)

The emphasis of the COPHIA program is the provision of home-based care and support services by multi-purpose community-based health workers to vulnerable households in the geographic focus areas that are coping with the burden of caring for seriously ill family members or caring for orphans and vulnerable children. The COPHIA community-based health workers, with the support of clinical and non-clinical supervisors, provide the direct physical and emotional care and support services to PLWHA and orphans and vulnerable children in the project catchment area with the support of trained primary caregivers.

Community Involvement Saves Newborn Infants in India

In a rural village in India, newborn deaths have been halved not by neonatologists or high-tech interventions but by local villagers trained in simple life-saving practices. Some experts, however, are sceptical about whether this strategy can work everywhere. [from author]

Empowering the People: Development of an HIV Peer Education Model for Low Literacy Rural Communities in India

Despite ample evidence that HIV has entered the general population, most HIV awareness programs in India continue to neglect rural areas. Low HIV awareness and high stigma, fueled by low literacy, seasonal migration, gender inequity, spatial dispersion, and cultural taboos pose extra challenges to implement much-needed HIV education programs in rural areas. This paper describes a peer education model developed to educate and empower low-literacy communities in the rural district of Perambalur in India. [from abstract]

Process and Effects of a Community Intervention on Malaria in Rural Burkina Faso: Randomized Controlled Trial

In the rural areas of sub-Saharan Africa, the majority of young children affected by malaria have no access to formal health services. Home treatment through mothers of febrile children supported by mother groups and local health workers has the potential to reduce malaria morbidity and mortality. [from author]

Enhanced Access to Reproductive Health and Family Planning

This report details the impact of Pathfinder Interational’s community-based approach to reproductive health and family planning in Ethiopia.

Thailand’s Unsung Heroes

The success of primary health care programmes in Thailand over the past three decades can be attributed not only to medical advances but to the role of community health volunteers. Buddhist monks and their temples have been strongly involved in health promotion and education, particularly in remote, rural communities. [from introduction]

Moving Towards Best Practice: Documenting and Learning from Existing Community Health Care Worker Programmes

The objectives of the study were to assess the extent to which CHW deployment has been addressing important health priorities; document success stories and lessons, identify champions; understand the range of ways that CHW programmes have evolved in South Africa and compile recommendations and lessons learned to improve practice. [from executive summary]

Impact of Home-Based Management of Malaria on Health Outcomes in Africa: a Systematic Review of the Evidence

Home-based management of malaria (HMM) is promoted as a major strategy to improve prompt delivery of effective malaria treatment in Africa. The published literature was searched for studies that evaluated the health impact of community- and home-based treatment for malaria in Africa. [from abstract]

Expanding the Role of Community Based Workers and Advocates in Safe Motherhood

Under the ENABLE Safe Motherhood Core Initiative, CEDPA/India collaborated with the Community Aid and Sponsorship Program on the Safe Motherhood Initiative to reduce maternal death by showing women, their families and their communities how to prepare for a safe delivery, to identify pregnancy-related complications at their onset, and to seek medical help immediately. [publisher’s description]

Village Health Team Strategy is a Most Innovative Community Practice Award Winner: the Experience of a Village Volunteer Programme in Yumbe District, Uganda

In Yumbe District of north-western Uganda, Village Health Teams (VHT) have been established in line with the national strategy for community involvement in health. The Yumbe VHT programme has won an award for innovative support to strengthening decentralisation. This paper reviews aspects of the programme outlining its successes and challenges.

Community Health Approach to Palliative Care for HIV/AIDS and Cancer Patients in Sub-Saharan Africa

Given the very limited health infrastructure and resources and the need to provide a palliative care service to about one percent of the population each year, community and home-based care is viewed as the key to responding to these needs. Some countries have already developed strong home-based care networks in coordination with the PHC system to respond to the HIV/AIDS epidemic. Palliative care, as part of the continuum of care of HIV/AIDS, cancer and other chronic conditions can be integrated into this existing network. [author’s description]