Community Interventions

Outreach Services to Improve Access to Health Care in South Africa: Lessons from Three Community Health Worker Programmes

This article examines three South African community health worker programs, a small local non-governmental organisation, a local satellite of a national NGO, and a government-initiated service, that provide a range of services from home-based care, childcare, and health promotion to assist clients in overcoming poverty-related barriers to health care to identify factors that constrain and enable outreach services to improve access to care. [from abstract]

Rapid Assessment of a Community Health Worker Pilot Programme to Improve the Mangement of Hypertension and Diabetes in Emfuleni Sub-Distric of Gauteng Province, South Africa

Using a rapid assessment, this study examines the outcomes of a pilot community health worker program to improve the management of hypertension and diabetes in Gauteng province, South Africa. [from abstract]

Taxonomy for Community-Based Care Programs Focused on HIV/AIDS Prevention, Treatment, and Care in Resource-Poor Settings

This review sought to develop taxonomy of community-based care programs focused on HIV/ AIDS in resource-limited settings in an effort to understand their key characteristics, uncover any gaps in programming, and highlight the potential roles they play. [from abstract]

Improving Outcomes with Community Health Workers

This program management unit explores some of the key components and lessons learned from designing and implementing community health worker programs within national primary healthcare
systems. [adapted from author]

Delivery of Preventive Care to Clients of Community Health Services

The objective of this study was to determine the prevalence of preventive care provided by community health clinicians; the association between client and service characteristics and receipt of care; and acceptability of care in order to inform interventions that facilitate adoption of opportunistic preventive care delivery. [adapted from abstract]

Promising Practices in Community Engagement for Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive

This review was commissioned to help address the information gap around the essential and complementary role of communities in prevention of mother to child transmission. In particular, this study sought to identify and share promising practices for community-based interventions that can strengthen programs and facilitate efforts to stop HIV transmission to children and enable their mothers to remain healthy. [adapted from author]

Applying a Framework for Assessing the Health System Challenges to Scaling up mHealth in South Africa

This paper applies a health systems perspective to guide analysis of potential challenges of scaling up mHealth for the monitoring and evaluation (M&E) of community-based health services (CBS) in South Africa. This formalisation of CBS is expected to bring greater standardisation of M&E and supervision systems for community health workers. [adapted from author]

Decision Making among Community-Based Volunteers Working in Vulnerable Children Programs

This study was collected data from caregivers who work directly with vulnerable children to explore how care decisions are made by community-based volunteers, and the utility of the Child Status Index at the community level as a job aid. [adapted from summary]

Successful Polio Eradication in Uttar Pradesh, India: The Pivotal Contribution of the Social Mobilization Network, an NGO/UNICEF Collaboration

This article reports on a successful partnership to improve access and reduce family and community resistance to polio vaccination in India. The partners trained thousands of mobilizers from high-risk communities to visit households, promote government-run child immunization services, track children’s immunization history and encourage vaccination of children missing scheduled vaccinations, and mobilize local opinion leaders. [adapted from author]

Lessons Learned from Scaling up a Community-Based Health Program in the Upper East Region of Northern Ghana

This paper describes the history of how an experimental study set the stage for a national program for promoting community-based primary health care—the Community-Based Health Planning and Services initiative, which deployed nurses to the community and engaged local leaders, reducing child mortality and fertility substantially. [adapted from author]

Effectiveness of a Community-Based Positive Prevention Intervention for People Living with HIV Who Are Not Receiving Antiretroviral Treatment: A Prospective Cohort Study

This controlled study aimed to assess the effectiveness of a personalized HIV risk-reduction intervention delivered by community health workers to people who know they have HIV and who are not on treatment. [from author]

Networking between Community Health Programs: A Case Study Outlining the Effectiveness, Barriers and Enablers

This research explores the factors that facilitate and impede community health network activation, framing, mobilisation and synthesis.India was selected as a case study as it represents a fertile context in which to explore community health networks given the diversity and density of community health NGOs and the dependency of the health care system on such providers. [adapted from author]

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]

Assessment of the Uptake of Neonatal and Young Infant Referrals by Community Health Workers to Public Health Facilities in an Urban Informal Settlement, KwaZulu-Natal, South Africa

The aim of this study was to assess the effectiveness of a referral system - where community health workers (CHW) were trained to refer babies with illnesses or identified danger signs - by describing CHW referral completion rates as well as mothers’ health-care seeking practices. [adapted from author]

Health Systems Supports for Community Case Management of Childhood Illness: Lessons from an Assessment of Early Implementation in Malawi

This paper presents the results of a mixed-methods assessment of selected health systems supports for community-based health workers in a national community case management program for childhood illness in Malawi during the first year of implementation. [adapted from abstract]

How Effective Are Community Health Workers? An Overview of Current Evidence with Recommendations for Strengthening Community Health Worker Programs to Accelerate Progress in Achieving the Health-Related Millennium Development Goals

The purpose of this review is to assess the effectiveness of community health worker programs, with particular emphasis on how they have or how they might assist countries in achieving the health-related MDGs.[from author]

Mobile Health (mHealth) Approaches and Lessons for Increased Performance and Retention of Community Health Workers in Low- and Middle-Income Countries: A Review

The aim of this article was to conduct a thematic review of how mHealth projects have approached the intersection of mobile technology and public health in low- and middle-income countries and identify the promising practices and experiences learned, as well as novel and innovative approaches of how mHealth can support community health workers. [adapted 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]

Provision of Injectable Contraceptives in Ethiopia through Community-Based Reproductive Health Agents

The objective of this study was to determine if, with appropriate training, volunteers known as community-based reproductive health agents can administer injectable contraceptives to women in a rural region of Ethiopia with the same effectiveness, safety and acceptability as health extension workers. [from author]

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]

Community Discussion Guide for Maternal and Newborn Health Care: A Training Manual for Safe Motherhood Action Groups

This guide contains detailed guidance on how to train safe motherhood action group volunteers in two key areas of their portfolio – maternal and newborn health care.

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]

Knowledge and Performance of the Ethiopian Health Extension Workers on Antenatal and Delivery Care: A Cross-Sectional Study

This study investigated the knowledge and performance of health extension workers (HEWs) on antenatal and delivery care. The study also explored the barriers and facilitators for HEWs in the provision of maternal health care. [from abstract]

Role of Health Extension Workers in Improving Utilization of Maternal Health Services in Rural Areas in Ethiopia: A Cross-Sectional Study

Ethiopia has been deploying specially trained cadres of community based health workers named health extension workers. This study investigates the role of these these community health workers in improving utilization of maternal health services. [adapted from abstract]

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]

Assessing Community Health Workers' Performance Motivation: A Mixed-Methods Approach on India's Accredited Social Health Activists (ASHA) Programme

This study examined the performance motivation of community health workers and its determinants on India’s Accredited Social Health Activist program. [from abstract]

Scale-Up of Home-Based Management of Malaria Based on Rapid Diagnostic Tests and Artemisinin-Based Combination Therapy in a Resource-Poor Country: Results in Senegal

In Senegal, an pilot study demonstrated the feasibility of a malaria treatment program in remote villages by volunteer home care providers. This paper reports the results of the scale-up in the targeted communities and the impact of the strategy on malaria in the formal health sector. [adapted from abstract]

Increasing Community Health Worker Productivity and Effectiveness: A Review of the Influence of the Work Environment

This article presents policy-makers and programme managers with key considerations for a model to improve the work environment as an important approach to increase community health worker productivity and, ultimately, the effectiveness of community-based strategies. [from abstract]

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]

Are Community Midwives Addressing the Inequities in Access to Skilled Birth Attendance in Punjab, Pakistan? Gender, Class and Social Exclusion

To address its high maternal mortality rate, in particular the inequities in access to maternal health care services, the government of Pakistan created a new cadre of community-based midwives. This study is designed to address a critical gap in our knowledge about whether this cadre of workers, operating in the private health care context, will meet the expectation to provide care to the poorest and most marginalized women. [adapted from author]