Video Spotlight

"'I'm a Health Worker' - Abduaraman Gidi" made by IntraHealth International.

Role and outcomes of community health workers in HIV care in sub-Saharan Africa: a systematic review

The provision of HIV treatment and care in sub-Saharan Africa faces multiple challenges, including weak health systems and attrition of trained health workers. One potential response to overcome these challenges has been to engage community health workers (CHWs). A systematic literature search for quantitative and qualitative studies describing the role and outcomes of CHWs in HIV care between inception and December 2012 in sub-Saharan Africa was performed.

Patient- and delivery-level factors related to acceptance of HIV counseling and testing services among tuberculosis patients in South Africa: a qualitative study with community health workers and program managers.

South Africa has a high tuberculosis (TB)-human immunodeficiency virus (HIV) coinfection rate of 73%, yet only 46% of TB patients are tested for HIV. To date, relatively little work has focused on understanding why TB patients may not accept effective services or participate in programs that are readily available in healthcare delivery systems.

Adapting the popular opinion leader intervention for Latino young migrant men who have sex with men.

Young Latino migrant men who have sex with men are at high risk for HIV infection. The Popular Opinion Leader intervention, shown to be effective with White gay men, was adapted by the Farmworker Justice Fund, Inc., for this Latino migrant population. This project, called the Young Latino Promotores, was implemented over a 2-year period by community-based organizations in Vista, California, and McAllen, Texas, based on the promotores de salud (community health worker) model, using people from the community to provide information in a culturally appropriate manner.

Pasa la voz (spread the word): using women's social networks for HIV education and testing.

Pasa la Voz (spread the word) is a human immunodeficiency virus (HIV) prevention methodology inspired by respondent-driven sampling (RDS) that uses social networks to access hard-to-reach populations. As field testing showed the approach to be efficacious among at-risk women in West Texas and Southern New Mexico, we set out to evaluate the methodology in a Mexican context. A local community organization, Programa Compañeros, first implemented a traditional one-on-one outreach strategy using promotoras (outreach workers) in Ciudad Juarez, Mexico, from September 2005 to January 2006.

Can community health workers improve adherence to highly active antiretroviral therapy in the USA? A review of the literature.

Highly active antiretroviral therapy (HAART) has transformed HIV infection into a manageable chronic illness, yet AIDS mortality among ethnic minorities persists in the USA. HAART nonadherence is associated with increased HIV viral load, low CD4 cell count and racial disparities in HIV outcomes. While there is no universal consensus on how to improve medical adherence in HIV-positive populations, the community health worker (CHW) model is emerging as an effective strategy to overcome barriers to HAART adherence.

The Impact of Paraprofessional versus Volunteer-Driven Home Visiting Programs on the Wellbeing of Orphans and Vulnerable Children: Evidence from a Longitudinal Evaluation in KwaZulu-Natal, South Africa

This brief describes the findings and program implications from a study designed to develop critical knowledge on “what works” to improve the well-being of children affected by HIV and AIDS.  Community-based home visiting, in which care workers provide a range of support services during regular visits to the child’s home, is an increasingly popular service delivery approach in South Africa. However, there is enormous variation in how home visiting programs are implemented.  The aim of the study is to evaluate the relative impact on child wellbeing of a range of home visiting models.

Integrating Nutrition Into HIV/AIDS Care and Support Programs

This HIV & Infant Feeding Question and Answer Guide is a reference tool to provide health workers with information concerning updated international guidelines related to HIV and infant feeding. Health workers can refer to the Guide to explain the issues related to HIV and infant feeding, provide information and support to help prevent HIV transmission from women to their children, and increase the safety of all infant feeding options.

Task shifting in HIV/AIDS service delivery: An exploratory study of expert patients in Uganda

This reports on a qualitative study conducted in May 2011 across six health facilities. It analyses the perspectives of expert patients, their supervisors and patients that they serve with regards to roles undertaken by expert patients and the support that they receive to undertake these roles. The report also provides recommendations for improvement and serves as a useful reference for programs and countries that are considering similar approaches.

Impact of a mHealth intervention for peer health workers on AIDS care in rural Uganda: a mixed methods evaluation of a cluster-randomized trial.

Mobile phone access in low and middle-income countries is rapidly expanding and offers an opportunity to leverage limited human resources for health. We conducted a mixed methods evaluation of a cluster-randomized trial exploratory substudy on the impact of a mHealth (mobile phone) support intervention used by community-based peer health workers (PHW) on AIDS care in rural Uganda. Qualitative analyses found improvements in patient care and logistics and broad support for the mHealth intervention among patients, clinic staff, and PHWs.

Peer Health Workers and AIDS Care in Rakai, Uganda: A Mixed Methods Operations Research Evaluation of a Cluster-Randomized Trial

Settings with limited health care workers are challenging environments for delivery of antiretroviral therapy. One strategy to address this human resource crisis is to task shift through training selected patients as peer health workers (PHWs) to provide care to other individuals receiving antiretroviral therapy.

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