Community Health Workers: An Underappreciated Asset to Tackle NCD

Jarvis, Jordan; Kataria, Ishu; Murgor, Mellany; Mbau, Lilian

doi:10.1016/j.gheart.2016.10.004

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…As such, CHWs need to be empowered to improve their own health behaviours and then to serve as a catalyst and role model by empowering the community members with increased knowledge and support. 56 The role that CHWs play in communities has been flagged as an empowerment strategy to reach communities with the aim of improving healthcare. Once communities are empowered there is an increase in the sense of self-determination and self-efficacy and a positive cycle of health behaviours may be perpetuated and sustained.…”

Section: Discussionmentioning

confidence: 99%

Challenges experienced by community health workers and their motivation to attend a self-management programme

Johnson

Schopp

Waggie

et al. 2022

African Journal of Primary Health Care & Family Medicine

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Background: Community health workers (CHWs) are change agents expected to assist in decreasing the global burden of disease in the communities they serve. However, they themselves have health risk behaviours, which predispose them to non-communicable diseases and thus need to be empowered to make better health choices. There is a gap in literature detailing the challenges faced by CHWs in addressing their own health risk behaviours.Aim: This study aimed to explore the challenges experienced by CHWs in carrying out their daily duties and the motivating factors to join a self-management programme.Setting: The study was conducted in a low socio-economic urban area of the Western Cape, South Africa.Methods: This study used a qualitative exploratory design using in-depth interviews to obtain rich data about the personal and professional challenges that CHWs experience on a daily basis.Results: Five themes emerged with regard to professional challenges (social conditions, mental health of patients, work environment, patient adherence and communication). This cadre identified ineffective self-management as a personal challenge and two themes emerged as motivation for participating in a self-management programme: empowerment and widening perspective.Conclusion: The challenges raised by the CHWs have a direct impact on their role in communities. This study therefore highlights an urgent need for policymakers and leaders who plan training programmes to take intentional strategic action to address their health challenges and to consider utilising a self-management intervention model to improve their overall health status.

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Section: Discussionmentioning

confidence: 99%

Challenges experienced by community health workers and their motivation to attend a self-management programme

Johnson

Schopp

Waggie

et al. 2022

African Journal of Primary Health Care & Family Medicine

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“…[20] It has been suggested that CHWs may be the 'secret weapon' to combat NCDs as they can effectively screen populations for NCD risk, act as agents of social change, facilitate information and education campaigns through existing social networks, and reach out to populations who have limited mobility and low decision-making power. [3,21,22] Our findings also highlight that the urban poor suffer disproportionately from interpersonal violence, which is a risk factor for poor health as it increases an individual's risk of substance abuse and mental health disorders, and inflicts poverty through school dropout, unemployment, and death or disability of a breadwinner. [23] As Nelson Mandela wrote, 'Many who live with violence day in and day out assume that it is an intrinsic part of the human condition.…”

Section: Researchmentioning

confidence: 78%

The unmet needs and health priorities of the urban poor: Generating the evidence base for urban community health worker programmes in South Africa

et al. 2018

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“…Other strategies to promote transparency could include top down methods of information access, where clinicians and or community health workers (CHW) regularly visit NCD households to provide support, education and information about available supplies. NCD care studies using CHW show the benefits of this direct access, and how this model could address NCD education and holistic aspects of health in addition to NCD medicine access [25].…”

Section: Recommendationsmentioning

confidence: 99%

Coping with access barriers to non‐communicable disease medicines: qualitative patient interviews in eight counties in Kenya

Raskin

Wirtz

et al. 2021

BMC Health Serv Res

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Background There is rich literature on barriers to medicines access for the treatment of non-communicable diseases (NCDs) in high-income countries. Less is known about low- and middle-income countries, in particular the differences in coping with medicines access barrier by household wealth and disease. The aim of this study was to compare the coping mechanisms of patients with the lack of availability and affordability of cardio-vascular diseases, diabetes and asthma medicines in Kenya. Methods This qualitative study was part of a larger mixed methods evaluation study conducted in eight counties of Kenya from 2016 to 2019. Forty-nine patient interviews at study end line explored their NCD journey, perceptions of availability, stockouts and affordability of NCD medicines, their enrollment in health insurance, and their relationship with the private chemists. Transcribed interviews were coded using Nvivo software. A two-step thematic approach was used, first conducting a priority coding which was followed by coding emerging and divergent themes. Results Overall, we found that patients across all disease types and wealth level faced frequent medicine stock-outs at health facilities. In the absence of NCD medicines at health facilities, patients coped by purchasing medicines from local chemists, switching health facilities, requesting a different prescription, admitting oneself to an inpatient facility, establishing connections with local staff to receive notifications of medicine stock, stocking up on medicines, utilizing social capital to retrieve medicines from larger cities and obtaining funds from a network of friends and family. Categorizing by disease revealed patterns in coping choices that were based on the course of the disease, severity of the symptoms and the direct and indirect costs incurred as a result of stockouts of NCD medicines. Categorizing by wealth highlight differences in households’ capacity to cope with the unavailability and unaffordability of NCD medicines. Conclusions The type of coping strategies to access barriers differ by NCD and wealth group. Although Kenya has made important strides to address NCD medicines access challenges, prioritizing enrollment of low wealth households in county health insurance programs and ensuring continuous availability of essential NCD medicines at public health facilities close to the patient homes could improve access.

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Community Health Workers: An Underappreciated Asset to Tackle NCD

Cited by 9 publications

References 19 publications

Challenges experienced by community health workers and their motivation to attend a self-management programme

Challenges experienced by community health workers and their motivation to attend a self-management programme

The unmet needs and health priorities of the urban poor: Generating the evidence base for urban community health worker programmes in South Africa

Coping with access barriers to non‐communicable disease medicines: qualitative patient interviews in eight counties in Kenya

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