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Fulltext Effectiveness of community health workers involvement in smoking cessation programme: A systematic review

Zulkiply SH, Ramli LF, Fisal ZAM, Tabassum B, Abdul Manaf R

PLoS One, 2020;15(11):e0242691.
PMID: 33211779 DOI: 10.1371/journal.pone.0242691

BACKGROUND: Sustainable Development Goals (SDG) has set the target to reduce premature mortalities from non-communicable diseases (NCDs) by one-third. One of the ways to achieve this is through strengthening the countries' implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). Community health workers (CHWs) involvement has shown promising results in the prevention of NCDs. This systematic review is aimed at critically evaluating the available evidence on the effectiveness of involving CHWs in smoking cessation.
MATERIALS AND METHODS: We systemically searched PubMed and CENTRAL up to September 2019. We searched for published interventional studies on smoking cessation interventions using the usual care that complemented with CHWs as compared to the usual or standard care alone. Our primary outcome was abstinence of smoking. Two reviewers independently extracted data and assessed study risks of bias.
RESULT: We identified 2794 articles, of which only five studies were included. A total of 3513 smokers with 41 CHWs were included in the studies. The intervention duration range from 6 weeks to 30 months. The studies used behavioral intervention or a combination of behavioral intervention and pharmacological treatment. Overall, the smoking cessation intervention that incorporated involvement of CHWs had higher smoking cessation rates [OR 1.95, 95% CI (1.35, 2.83)]. Significant smoking cessation rates were seen in two studies.
CONCLUSION: Higher smoking cessation rates were seen in the interventions that combined the usual care with interventions by CHWs as compared to the usual care alone. However, there were insufficient studies to prove the effectiveness. In addition, there was high heterogeneity in terms of interventions and participants in the current studies.

Matched MeSH terms: Community Health Workers*
Fulltext Female Community Health Workers and Health System Navigation in a Conflict Zone: The Case of Afghanistan

Parray AA, Dash S, Ullah MIK, Inam ZM, Kaufman S

Front Public Health, 2021;9:704811.
PMID: 34458226 DOI: 10.3389/fpubh.2021.704811

Afghanistan ranked 171st among 188 countries in the Gender Inequality Index of 2011 and has only 16% of its women participating in the labor force. The country has been mired in violence for decades which has resulted in the destruction of the social infrastructure including the health sector. Recently, Afghanistan has deployed community health workers (CHW) who make up majority of the health workforce in the remote areas of this country. This paper aims to bring the plight of the CHWs to the forefront of discussion and shed light on the challenges they face as they attempt to bring basic healthcare to people living in a conflict zone. The paper discusses the motivations of Afghani women to become CHWs, their status in the community and within the health system, the threatening situations under which they operate, and the challenges they face as working women in a deeply patriarchal society within a conflict zone. The paper argues that female CHWs should be provided proper accreditation for their work, should be allowed and encouraged to progress in their careers, and should be instilled at the heart of healthcare program planning because they have the field experience to make the most effective and community oriented programmatic decisions.

Matched MeSH terms: Community Health Workers*
Fulltext Health care in Sarawak's jungles

Chen PCY

World Health Forum, 1989;10(2):190-2.
PMID: 2610830

A primary health care system is being developed in Baram District, Sarawak, Malaysia, for the benefit of the Penans, who, until recently, were largely nomadic. Many of them are now attempting to adopt a settled mode of existence, and this in itself creates special health problems because the people lack the skills needed for living in one place. Substantial progress has already been achieved in mother and child care and in immunization coverage.

Matched MeSH terms: Community Health Workers/education
The indigenous midwife in Asia--supporter or opponent of family planning?

Simons J

IPPF Med Bull, 1975 Oct;9(5):1-3.
PMID: 12258616

PIP: A traditional birth attendant, also known as an indigenous midwife, is the main provider in many developing countries of obstetric services. Due to this unique position, the traditional birth attendant has been considered as possibly the ideal person to deliver family planning services in her local community. This consideration has influenced program policy in many countries and consequently there is information available to aid in the determination of whether to involve traditional birth attendants and, if so, how to best use them. There have been 2 opposing views in response to the involvement of traditional birth attendants. 1 view regards them as potential innovators. She is seen as ideally placed both physically and socially to act as a representative of the family planning program to her patients. The traditional birth attendant is the acknowledged and often prestigous expert on obstetrics matters, including at times traditional methods of birth control. The alternative view is less hopeful for rather than identifying the traditional birth attendant as an innovator it regards her as a firm opponent of innovation, a determined conventionalist. Pro gram experience in India, Pakistan, Indonesia and East Java and experime ntal studies in the Philippines, Malaysia, and Thailand along with anthr opological inquiries generally support the skeptical view but none of the findings imply that the traditional birth attendant should be ignored by the family planning programs. In the intermediate positions of many actual programs, the wisest plan seems to be to ensure that the potential contribution of the traditional birth attendant is neither overlooked nor exaggerated

Matched MeSH terms: Community Health Workers*
Village midwives in Malaysia

Peng JY, Laily N, Bakar A, Bin Marzuki A

Stud Fam Plann, 1972 Feb;3(2):25-8.
PMID: 4656053 DOI: 10.2307/1965087

PIP: 292 village midwives (bidans) in Malaysia were interviewed between January 1969 and December 1970 as they came to report for training. The mean age was 47.3, 80% had had no schooling, 43% had practiced less than 10 years (32% between 10 and 20 years, 21% between 20 and 30 years, and 4% more than 30 years). On the average each bidan reported attending 3 deliveries during the past month and 26 during the past year. The average charge per delivery was about U.S.$2.00. Of 267 who responded to a question concerning other services they provided, 50% said they performed massages, 30% performed massages combined with other services, 12% said they did not do anything other than midwifery and 7% prescribed herbs and performed abortions. 67% said they first had contact with the mother during the seventh to ninth month of pregnancy, 42% between the fourth and sixth month, and 7% at or before the third month. 40% said the postpartum care lasted less than 1 week, 40% from 1-2 weeks and 19% between 2-7 weeks. Only 2 out of 198 bidans disapproved of family planning services. 99% were not worried that this would affect their job in conducting deliveries. 62% had been approached by women about family planning information services during the last 3 months. 95% thought they could help to promote the government's program by recruiting patients and distributing contraceptives. Since oral contraceptives are the most frequently used contraceptive in Malaysia, bidans could resupply the women with the pill. They could play an important role in promoting contraceptive continuation in rural areas by providing women with a continuous motivation through their constant contact. The success of using bidans in rural family planning services will greatly depend on their supervision. They can be paid with a flat salary-type payment, with an incentive scheme alone, or a combination of the two.

Matched MeSH terms: Community Health Workers/utilization
The role of the community and medical auxiliaries in the prevention of diarrhoeal diseases of children in Sarawak, Malaysia

Chen PC

Southeast Asian J Trop Med Public Health, 1982 Sep;13(3):441-5.
PMID: 7163853
Matched MeSH terms: Community Health Workers*
Fulltext A primary health care project in Sarawak

Chen PCY, Tan YK

Med J Malaysia, 1982 Mar;37(1):25-34.
PMID: 7121343

A joint pilot project between the Ministry of Health and the Department of Social and Preventive Medicine, University of Malaya, to test the value of village aides in extending the health care system into isolated Iban communities was started in May 1979 in the Entabai District of Sarawak. A group of 15 village aides consisting of 11 traditional Iban manangs (medicine-men) and 4 youths were trained to provide primary health care including simple curative care, preventive care and to assist in the detection of malaria. Evaluation carried out 2 years later showed the following. In respect of curative care, the village aides were each, on the average, treating 70.6 patients per month, the most common illness being headaches (30.4 percent), which together with abdominal pain, constipation, bodyaches, diarrhoea, vomiting, fever, worm infestations, cough and sore throat, accounted for 89 percent of all illnesses seen by them. Subsequent to the introduction of village aides in the project area, the number ofseriously ill patients requiring admission to the rest beds of the klinik desa dropped by 43.8 percent and the number of emergency referrals to the back-up divisional hospitals fell by 46.1 percent showing that patients were coming to the klinik desa for treatment at an earlier stage. The 11 traditional Iban manangs, who had received training had, on their own accord, drastically reduced the use of traditional Iban modes of therapy in preference for "modern" medicine. During the 24 months immediately after the introduction of village aides into Entabai, 9 gravity feed water supply systems together with the related "health package" advocating general cleanliness, the use of latrines andfences were effected, whereas only 6 such systems were installed in the previous 24 months, indicating that it is likely that the village aides were of some assistance in mobilizing the community is respect of these self-help efforts. During the same period, the majority of longhouses in the area successfully established a number of vegetable gardens growing foods for home consumption, and continue to vigorously advocate breast feeding of infants in opposition to bottle feeding. During the 23 months after village aides were introduced, a total of 1,093 blood films were collected by the 15 village aides, the average number of blood films per village aide being 3.2 blood slides per month. Village aides are socially accepted by the Iban community who utilize their curative skills when mild illnesses disturb them, but who proceed directly to the klinik desa when more serious illnesses such as fevers strike them. The project has established clear lines of communication between the health team and the community, and has stimulated the community to organize itself to achieve an increasingly high level of health through community participation and self reliance. Plans have been approved in principle to train a further 2000 village aides in primary health care for the state of Sarawak.

Matched MeSH terms: Community Health Workers/education; Community Health Workers/utilization*
Fulltext Female community health volunteers to reduce blood pressure: feasible and sustainable?

Bhuvan KC, Khanal S

Lancet Glob Health, 2018 04;6(4):e373.
PMID: 29530416 DOI: 10.1016/S2214-109X(18)30034-2
Matched MeSH terms: Community Health Workers
Providing primary health care with non-physicians

Chen PC

Ann Acad Med Singap, 1984 Apr;13(2):264-71.
PMID: 6497324

The definition of primary health care is basically the same, but the wide variety of concepts as to the form and type of worker required is largely due to variations in economic, demographic, socio-cultural and political factors. Whatever form it takes, in many parts of the developing world, it is increasingly clear that primary health care must be provided by non-physicians. The reasons for this trend are compelling, yet it is surprisingly opposed by the medical profession in many a developing country. Nonetheless, numerous field trials are being conducted in a variety of situations in several countries around the world. Non-physician primary health care workers vary from medical assistants and nurse practitioners to aide-level workers called village mobilizers, village volunteers, village aides and a variety of other names. The functions, limitations and training of such workers will need to be defined, so that an optimal combination of skills, knowledge and attitudes best suited to produce the desired effect on local health problems may be attained. The supervision of such workers by the physician and other health professionals will need to be developed in the spirit of the health team. An example of the use of non-physicians in providing primary health care in Sarawak is outlined.

Matched MeSH terms: Community Health Workers/statistics & numerical data*
Primary health care among the Iban of Sarawak

Chen PC, Tan YK

Trop Geogr Med, 1981 Dec;33(4):403-9.
PMID: 7342391
Matched MeSH terms: Community Health Workers/education*
Family development: a classic example

Bul Keluarga, 1979 Jul-Aug;97:4-5, 8.
PMID: 12261448

PIP: On August 15, 1978, the integrated parasite control/family planning program was launched by the National Family Planning Board in the Tanjong Malim Estate in Kuala Lumpur (the estate is a rubber oil palm plantation) to enhance the health status of the estate workers and their families. Personal hygiene, good toilet habits, and washing fruits and vegetables before eating were emphasized. Pre- and post-surveys of worm infestation of the estate population revealed that treatment with drugs dramatically reduced the rate of intestinal helminthiasis infection among the population. To sustain the prevention or total eradication of the disease, an ongoing educational program was initiated and included the following features: 1) increasing knowledge of the community as to how intestinal helminthiasis is transmitted, and ways of limiting transmission; 2) providing safe and sanitary toilet facilities for young children, and; 3) periodic deworming of susceptible population every 3 months. The estate members are also encouraged to plant vegetables in their backyard. The National Family Planning Board also helped the estate members organize different functional groups, such as Mothers' Group. This multifaceted approach to family planning appears to have an encouraging future, particularly in family development.

Matched MeSH terms: Community Health Workers*
The medical auxiliary in rural Malaysia

Chen PC

Lancet, 1973 May 05;1(7810):983-5.
PMID: 4121603
Matched MeSH terms: Community Health Workers/statistics & numerical data
Child-to-Child programme in Malaysia

Kasim MS, Abraham S

Southeast Asian J Trop Med Public Health, 1982 Sep;13(3):459-63.
PMID: 7163857

Even though Malaysia is a relatively prosperous country amongst the developing nations, it is still be set by problems of a rapidly increasing population. The economic cake is also unevenly distributed and there are pockets of poverty in the slums surrounding the towns as well as in the rural areas. Added to that is the problem of ignorance and superstition especially amongst its adult population. It is due to these problems that the Child-to-Child programme has found special application in Malaysia. The Child-to-Child has been introduced through either the government agencies or the voluntary organizations. Through the Ministry of Education, the concept has found its ways through the schools and the state department of education. The Ministry of Information and Broadcasting has also introduced the concept of Child-to-Child in the media. The voluntary organizations have also introduced the concept of Child-to-Child in their projects. The Sang Kancil project has to some extent used the idea in the running of its activities. The Health and Nutrition Education House have found that by applying the concept and using older children to help in running its activities, its over all objective which is the improvement of the health of the children in the slums could be reached more easily.

Matched MeSH terms: Community Health Workers*
Developing primary health care for a nomad tribe: the Penans of the Baram

Chen PCY

Asia Pac J Public Health, 1987;1(1):34-7.
PMID: 3452377 DOI: 10.1177/101053958700100109

Unlike much of Peninsular Malaysia, the Baram District of Sarawak remains sparsely populated and underserved, one of the most underserved peoples being the nomadic and semi-nomadic Penans of the Baram. Until quite recently these Penans lived as small nomadic bands of hunter-gatherers. More recently, they have begun to settle in longhouses. However, lacking the necessary skills to live a settled mode of life, these Penans suffer a great deal of hunger, malnutrition, disease and death. Primary health care with its emphasis on the seven essential elements, including food production and nutrition, environmental sanitation, good maternal and child health, knowledge of disease and how it can be prevented as well as the treatment and control of locally endemic diseases, is of critical value in the survival of the semi-nomadic Penans. The specially designed primary health care programme for the Penans of the Baram is outlined briefly in this paper.
Keyword: Baram, Penans, Primary Health Care, Sarawak, Village Health Promoter.

Matched MeSH terms: Community Health Workers
Village midwives deliver

Peng JY

IDRC Rep, 1977;6(2):8.
PMID: 12335042
Matched MeSH terms: Community Health Workers
A sensitive approach to family planning motivation in Malaysia

Asian Pac Popul Programme News, 1978;7(4):30-2.
PMID: 12277967

PIP: The goals of the Malaysian Family Planning Program are not only to reduce population growth from 3% to 2% by 1985 and to bring the crude birth rate to 28.2 from 30.3, but to generally improve the health of the family, and to enhance the government's efforts to raise the per capita income. The work program is divided into the Creative Unit, the Media Unit, the Production Unit, and the Field Diffusion Unit. The objectives are to build up strong support from political, community, and opinion leaders, and to run educational campaigns aimed at motivating potential acceptors. The program also runs centers training medical and paramedical personnel. The program is combined with development programs for women, especially useful among the rural population.

Matched MeSH terms: Community Health Workers*
IBFAN Africa training initiatives: code implementation and lactation management

Mbuli A

Mothers Child, 1994;13(1):5.
PMID: 12287932
Matched MeSH terms: Community Health Workers*
Role of village practitioners in family planning service delivery system

Rahman S

Malays J Reprod Health, 1985 Dec;3(2):133-7.
PMID: 12314740
Matched MeSH terms: Community Health Workers*
Maternity services and the role of the traditional birth attendant, bidan kampung, in rural Malaysia

Ali A, Howden-Chapman P

J Public Health Manag Pract, 2007 May-Jun;13(3):278-86.
PMID: 17435495 DOI: 10.1097/01.PHH.0000267686.08282.3c

This study was undertaken to explore the roles played by bidan kampungs and understand their contribution to rural Malay women during pregnancy and childbirth hundred sixteen pregnant women, 13 Western midwives, and 12 bidan kampungs were recruited using convenience and snowball sampling. Data were collected from focus groups, in-depth interviews, field notes, and observations. The findings indicated that although the women were happy to have Western maternity care, they valued the social and spiritual support received from bidan kampungs during pregnancy and postnatal care. Western care was considered useful for "modern" illnesses. The traditional maternity care that women received included pantang or ritual prohibitions that helped them through pregnancy and helped them achieve better postnatal recovery. The study indicates that there is a need to combine Western and traditional care for the benefit of the pregnant women and their infants' health.

Matched MeSH terms: Community Health Workers/supply & distribution*
Thai midwives brought into family planning

IDRC Rep, 1974 Mar;3(1):17-20.
PMID: 12333530

PIP: In Thailand "granny" midwives are being tested and trained to take part in modern family planning and public health programs. In Malaysia a survey of conditions relating to an increase in induced early termination or abortion of pregnancies is in progress. The International Development Research Centre (IDRC) supports these projects as well as others in Asia. Local paramedical workers, like the "barefoot doctors" in China, are being trained. In Thailand a growth plan is attempting to reduce the annual rate of population increase from about 3.3% to 2.5%. Many granny midwives have been contacted. Several methods of incentive and training are being tried and will be evaluated. Eventually granny midwives in all of Thailand's 60,000 villages will be enlisted in the national planning program. Of Thailand's 6 million married women of reproductive age less than half use modern birth control methods. Abortion is illegal in Thailand which is a predominantly Buddhist country. The project in Malaysia is being carried out by the University of Malaysia and the Federation of Family Planning Associations. Abortion is also illegal in Islamic Malaysia, although there are illegal abortion clinics. Trends so far reported to IDRC indicate that 1) lower class women are more cooperative interviewees than others, 2) most couples use some method of birth control, 3) many wish to interrupt their pregnancies, 4) poorer families have more children than wealthier ones, 5) the Chinese and Indian people show a greater tendency to limit families than do the Malays, and 6) most couples want 3 or 4 children.

Matched MeSH terms: Community Health Workers

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