CHW ISSUE RESEARCH-ROUND UP, ISSUE 001

Oct 15-Oct 29, 2018

  1. Improving Community Health Worker performance by using a personalised feedback dashboard for supervision: a randomised controlled trial

    • Comments: By our own team Muso + Medic! Way to go!

    • Methods: RCT; N=148 CHW; follow-up=6 months

    • Takeaway: Use of a personalised performance dashboard (metrics: quantity, speed, and quality of CHW care) during monthly supervision upped quantity of care without compromising speed or quality. (mean number of home visits increased significantly while effects on secondary outcomes of timeliness and quality were positive but not statistically significant) 

  2. Can community health worker home visiting improve care-seeking and maternal and newborn care practices in fragile states such as Afghanistan?

    • Methods: non-randomised trial; 2 int districts (289 CHW), 2 control districts; follow-up=12 months

    • Takeaway: CHW home visiting during the antenatal and postnatal periods can improve health service use (Facility delivery, Attendance for at least one antenatal care +postnatal care visit) in fragile- and conflict-affected countries

  3. The use of participatory visual methods with community health workers: A systematic scoping review of the literature

    • Comments: From our friends at Oxford, James! Interesting re: role of human-centred design in CHW program design/implementation

    • Methods: Systematic scoping review

    • Takeaway: Participatory visual methodologies (e.g. participatory photography, film, digital storytelling, mapping, and drawing - PVMs) can help assist CHWs' reflective practice, understanding of complex health issues, identifying key issues in the community to potentially leverage social action.

  4. Effectiveness of village health worker delivered smoking cessation counseling in Viet Nam

    • Comment: Interesting re: role of CHWs for NCDs

    • Methods: quasi-experimental study; health care provider advice and assistance (Arm 1) vs. Arm 1 plus CHW counseling; N=1,318 tobacco users; 6 month follow-up

    • Takeaway: Evidence for a team approach to tobacco dependence treatment: smokers in Arm 2 were almost three times more likely to quit compared with those in Arm 1.   

  5. A new tool to measure approaches to supervision from the perspective of community health workers: a prospective, longitudinal, validation study in seven countries

    • Comment: From our friends at the REACH-OUT Consortium

    • Methods: development +  validation of a simple tool to measure perceived supervision across seven LMICs

    • Takeaway: The  6-item measure of perceived supervision (capturing regular contact, two-way communication, and joint problem-solving elements - PSS) is the first validated tool that measures supervisory experience from the perspective of CHWs; available in 11 languages

  6. The predictive validity of the Living Goods selection tools for community health workers in Kenya: cohort study

    • Comment: From our own Celia Taylor + the Living Goods team! 

    • Methods: cohort study of CHWs working for LG in 8 districts (N=547); Kendall's tau-b correlations between each selection score and performance outcome were calculated

    • Takeaway:  None of the correlations between selection scores and outcomes (e.g. number of household and pregnancy registrations, number of child assessments, proportion of on-time follow-ups and value of goods sold) reached the 0.3 threshold of an "adequate" predictor of performance. N.B. important outcomes, retention in post and quality of care were not included in study.

  7. Effect of Community Health Worker Support on Clinical Outcomes of Low-Income Patients Across Primary Care Facilities

    • Comment: From our friends at the Penn Center, Shreya et. al!

    • Methods: RCT; N=592 patients; follow-up: 6, 9 months

    • Takeaway: CHW intervention reduced total hospital days by 65% while doubling quality!

  8. Oh, and the WHO Guidelines on optimizing CHW programs!! (Full here, abridged here)

Interesting trial registrations:

  1. Implementing community health worker-patient pairings at the time of hospital discharge: A randomized control trial (Clinical Trials.gov ID# NCT03085264)

    • Methods: RCT designed to determine if linking hospitalized patients with chronic disease to CHWs can decrease 30-day readmissions (USA)