Community Health Workers and Covid-19 — Addressing Social Determinants of Health in Times of Crisis and Beyond

Peretz, Patricia; Islam, Nadia; Matiz, Luz Adriana

doi:10.1056/nejmp2022641

Cited by 162 publications

(144 citation statements)

References 3 publications

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“…However, scaling up of these programs and integrating these within the existing healthcare delivery systems are important to deliver ongoing general health as well as NCD related services in Bangladesh. While the ongoing problem of COVID-19 is increasing, the roles of CHWs have been even crucial to delivering regular health services as well as COVID-19 preventive and management care [43,44]. Available evidence shows that the people with chronic conditions are highly affected by COVID-19 (high mortality) than the general population, hence, the role of CHWs to effectively provide NCD care during the ongoing COVID-19 pandemic has critical public health importance [45].…”

Section: Discussionmentioning

confidence: 99%

Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study

Rawal

Jubayer

Choudhury

et al. 2021

glob health res policy

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Background The increasing burden of Non-Communicable Diseases (NCDs) in Bangladesh underscores the importance of strengthening primary health care systems. In this study, we examined the barriers and facilitators to engaging Community Health Workers (CHWs) for NCDs prevention and control in Bangladesh. Methods We used multipronged approaches, including a. Situation analyses using a literature review, key personnel and stakeholders’ consultative meetings, and exploratory studies. A grounded theory approach was used for qualitative data collection from health facilities across three districts in Bangladesh. We conducted in-depth interviews with CHWs (Health Inspector; Community Health Care Provider; Health Assistant and Health Supervisor) (n = 4); key informant interviews with central level health policymakers/ managers (n = 15) and focus group discussions with CHWs (4 FGDs; total n = 29). Participants in a stakeholder consultative meeting included members from the government (n = 4), non-government organisations (n = 2), private sector (n = 1) and universities (n = 2). Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data analyses. Results The CHWs in Bangladesh deliver a wide range of public health programs. They also provide several NCDs specific services, including screening, provisional diagnosis, and health education and counselling for common NCDs, dispensing basic medications, and referral to relevant health facilities. These services are being delivered from the sub-district health facility, community clinics and urban health clinics. The participants identified key challenges and barriers, which include lack of NCD specific guidelines, inadequate training, excessive workload, inadequate systems-level support, and lack of logistics supplies and drugs. Yet, the facilitating factors to engaging CHWs included government commitment and program priority, development of NCD related policies and strategies, establishment of NCD corners, community support systems, social recognition of health care staff and their motivation. Conclusion Engaging CHWs has been a key driver to NCDs services delivery in Bangladesh. However, there is a need for building capacity of CHWs, maximizing CHWs engagement to NCD services delivery, facilitating systems-level support and strengthening partnerships with non-state sectors would be effective in prevention and control efforts of NCDs in Bangladesh.

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Section: Discussionmentioning

confidence: 99%

Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study

Rawal

Jubayer

Choudhury

et al. 2021

glob health res policy

View full text Add to dashboard Cite

show abstract

“…To relieve the cost burden of testing, federal provisions supporting cost-free COVID testing for insured and uninsured people should be continued [24]. Expedited contact tracing should proceed with tracers employing community health workers and other trusted figures with access to far-reaching community networks [25].…”

Section: African Americans and Covid-19 Illnessmentioning

confidence: 99%

“…Less attached to the health care system and living where there is less COVID infrastructure, African Americans have fewer opportunities for diagnosis and early treatment and less awareness of programs to defray uncovered costs [32]. Community health workers should be employed who can assist with African Americans' access to community resources and at-home care during recovery [25].…”

Section: African Americans and Covid-19 Illnessmentioning

confidence: 99%

COVID-19, Social Determinants Past, Present, and Future, and African Americans’ Health

Snowden

Graaf

2020

J. Racial and Ethnic Health Disparities

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As the COVID-19 pandemic progresses, more African Americans than whites are falling ill and dying from the virus and more are losing livelihoods from the accompanying recession. The virus thereby exploits structural disadvantages, rooted partly in historical and contemporary anti-Black sentiments, working against African Americans. These include higher rates of comorbid illness and more limited health care access, higher rates of disadvantageous labor market positioning and community and housing conditions, greater exposure to long-term care residence, and higher incarceration rates. COVID-19 also exposes African Americans' greater vulnerability to recession, and possibly greater susceptibility to accompanying behavioral health problems. If they are left unaddressed, the very vulnerabilities COVID-19 exploits may perpetuate themselves. However, continuing and supplementing health and economic COVID mitigation policies can disproportionately benefit African Americans and reduce short-and long-term adverse effects. The greater impact of COVID-19 on African Americans demonstrates the consequences of pervasive social and economic inequality and marks this as a critical time to prevent further compounding of adverse effects. Keywords African American health disparities. COVID-19. African American economic disparities. Policy

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“…With over 9,00,000 engaged ASHAs (January 2019), the community health workers (CHW) known as ASHAs in India have come a long way since its initiation in 2005, forming a sustainable frontline workforce of the Indian public healthcare system (National Health Systems Resource Centre 2019). In fact, in response to the COVID-19 pandemic, prioritizing in CHW has been suggested as one of the most equitable and efficient ways to uphold the stumbling healthcare system around the world (Bose 2020; Peretz et al 2020). Therefore, critical assessment of adequate knowledge on transmission, clinical presentations, prevention strategies among the CHW including ASHAs of India are indispensable during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

Assessment of knowledge, attitude and practices among Accredited Social Health Activists (ASHAs) towards COVID-19: a descriptive cross-sectional study in Tripura, India

Chowdhury¹,

Baidya

Paul³

et al. 2021

Preprint

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With the surge in COVID-19 cases, community healthcare workers (CHW) remain pivotal for proper dissemination of awareness of disease transmission and infection control measures among the communities in low- and middle-income countries. In this context, lack of adequate knowledge and appropriate attitude among the CHW can directly influence the COVID-19 management programme. Therefore, the present study was designed to assess the knowledge, attitude and practices towards COVID-19 among the CHW of India known as Accredited Social Health Activists (ASHAs). A descriptive cross-sectional was conducted in the state of Tripura, Northeast India, among ASHAs with 14-, 4- and 3- item self-administered questionnaire for knowledge, attitude and practice. Around 61.2% of participants had the mean correct answer rate and the mean score of knowledge was 8.57 ± 2.25 (±SD). As per Bloom′s cut-off, it was observed that only 10% of the ASHAs had adequate knowledge, 30.9% showed positive attitude and 88% adhered to the good practices. It was observed that the indigenous ASHAs were 1.79 times more likely to adhere to the good practice of wearing masks during filed visits in the community (OR: 1.791, 95% CI: 1.059-3.028, p=0.030). Multinomial regression analysis showed that practice was significantly associated with fear of getting infected during service and the community′s fearfulness of ASHAs spreading the disease. Urgent addressing of the provisions of support, guidance and training of grassroot level healthcare workers in rural tough terrains can ensure robust output from the existing community healthcare workers in future pandemic-like emergencies.

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Community Health Workers and Covid-19 — Addressing Social Determinants of Health in Times of Crisis and Beyond

Cited by 162 publications

References 3 publications

Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study

Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study

COVID-19, Social Determinants Past, Present, and Future, and African Americans’ Health

Assessment of knowledge, attitude and practices among Accredited Social Health Activists (ASHAs) towards COVID-19: a descriptive cross-sectional study in Tripura, India

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