TY - JOUR
T1 - Evaluating the impact of a community health worker programme on non-communicable disease, malnutrition, tuberculosis, family planning and antenatal care in Neno, Malawi
T2 - protocol for a stepped-wedge, cluster randomised controlled trial
AU - Dunbar, Elizabeth L.
AU - Wroe, Emily B.
AU - Nhlema, Basimenye
AU - Kachimanga, Chiyembekezo
AU - Gupta, Ravi
AU - Taylor, Celia
AU - Michaelis, Annie
AU - Cundale, Katie
AU - Dullie, Luckson
AU - Jumbe, Arnold
AU - Nazimera, Lawrence
AU - McBain, Ryan
AU - Lilford, Richard J.
AU - Watson, Samuel Ian
PY - 2018/7
Y1 - 2018/7
N2 - Introduction This protocol concerns the implementation and evaluation of an intervention designed to realign the existing cadre of community health workers (CHWs) in Neno district, Malawi to better support the care needs of the clients they serve. The proposed intervention is a 'Household Model' where CHWs will be reassigned to households, rather than to specific patients with HIV and/or tuberculosis (TB). Methods and analysis Using a stepped-wedge, cluster-randomised design, this study investigates whether high HIV retention rates can be replicated for non-communicable diseases (NCDs), and the model's impact on TB and paediatric malnutrition case finding, as well as the uptake of family planning and antenatal care. Eleven sites (health centres and hospitals) were arranged into six clusters (average cluster population 21 800). Primary outcomes include retention in care for HIV and chronic NCDs, TB case finding, paediatric malnutrition case finding, and utilisation of early and complete antenatal care. Clinical outcomes are based on routinely collected data from the Ministry of Health's District Health Information System 2 and an OpenMRS electronic medical record supported by Partners In Health. Additionally, semistructured qualitative interviews with various stakeholders will assess community perceptions and context of the Household Model.
AB - Introduction This protocol concerns the implementation and evaluation of an intervention designed to realign the existing cadre of community health workers (CHWs) in Neno district, Malawi to better support the care needs of the clients they serve. The proposed intervention is a 'Household Model' where CHWs will be reassigned to households, rather than to specific patients with HIV and/or tuberculosis (TB). Methods and analysis Using a stepped-wedge, cluster-randomised design, this study investigates whether high HIV retention rates can be replicated for non-communicable diseases (NCDs), and the model's impact on TB and paediatric malnutrition case finding, as well as the uptake of family planning and antenatal care. Eleven sites (health centres and hospitals) were arranged into six clusters (average cluster population 21 800). Primary outcomes include retention in care for HIV and chronic NCDs, TB case finding, paediatric malnutrition case finding, and utilisation of early and complete antenatal care. Clinical outcomes are based on routinely collected data from the Ministry of Health's District Health Information System 2 and an OpenMRS electronic medical record supported by Partners In Health. Additionally, semistructured qualitative interviews with various stakeholders will assess community perceptions and context of the Household Model.
KW - community child health
KW - community health
KW - community health workers
KW - integrated care
KW - primary care
UR - http://www.scopus.com/inward/record.url?scp=85050482976&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2017-019473
DO - 10.1136/bmjopen-2017-019473
M3 - Article
C2 - 30007924
AN - SCOPUS:85050482976
SN - 2044-6055
VL - 8
JO - BMJ Open
JF - BMJ Open
IS - 7
M1 - e019473
ER -
