Evaluation of the effectiveness of community health workers in the fight against malaria in the Central African Republic (2012–2017)

Ferdinand, Djerandouba Yotobumbeti; Nadlaou, Bessimbaye; Nzalapan, Samuel; Oscar, Bekaka Youlet; Mbaïlao, Raphaël; Christophe, Ndoua; Lopes, Sérgio; Allan, Richard

doi:10.1093/trstmh/trz104

Cited by 7 publications

(11 citation statements)

References 5 publications

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“…Our review found evidence that CHWs lead to more widespread appropriate referrals for Gambiense-type human African trypanosomiasis ( Palmer et al. , 2014 ) and malaria ( Ferdinand et al. , 2020 ).…”

Section: Resultsmentioning

confidence: 99%

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The role of community health worker-based care in post-conflict settings: a systematic review

Werner

Kak

Herbst

et al. 2022

Health Policy and Planning

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Countries affected by conflict often experience the deterioration of health system infrastructure and weakened service delivery. Evidence suggests that healthcare services that leverage local community dynamics may ameliorate health system-related challenges, however, little is known about implementing these interventions in contexts where formal delivery of care is hampered subsequent to conflict. We reviewed the evidence on community health worker (CHW)-delivered healthcare in conflict-affected settings and synthesized reported information on the effectiveness of interventions and characteristics of care delivery. We conducted a systematic review of studies in OVID MedLine, Web of Science, Embase, Scopus, CINHAL, and Google Scholar databases. Included studies (1) described a context that is post-conflict, conflict-affected, or impacted by war or crisis; (2) examined the delivery of healthcare by CHWs in the community; (3) reported a specific outcome connected to CHWs or community-based healthcare (CBHC); (4) were available in English, Spanish, or French; and (5) were published between 1 January 2000 and 6 May 2021. We identified 1976 articles, of which 55 met the inclusion criteria. Nineteen countries were represented, and five categories of disease were assessed. Evidence suggests that CHW interventions not only may be effective but also efficient in circumventing the barriers associated with access to care in conflict-affected areas. CHWs may leverage their physical proximity and social connection to the community they serve to improve care by facilitating access to care, strengthening disease detection, and improving adherence to care. Specifically, case management (e.g. integrated community case management) were was documented to be effective in improving a wide range of health outcomes and should be considered as a strategy to reduce barrier to access in hard-to-reach areas. Furthermore, task-sharing strategies have been emphasized as a common mechanism for incorporating CHWs into health systems

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Section: Resultsmentioning

confidence: 99%

“…, 2019 ; Van Boetzelaer et al. , 2019 ; Ferdinand et al. , 2020 ) and one used a simulation model ( Stijntjes, 2015 ).…”

Section: Resultsmentioning

confidence: 99%

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The role of community health worker-based care in post-conflict settings: a systematic review

Werner

Kak

Herbst

et al. 2022

Health Policy and Planning

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“…Politically, in recent years, different armed groups have been expanding their spheres of influence and controlling the country’s rich mineral resources through several rebellions, further contributing to violence and human rights abuses and causing serious political instability [ 3 ]. Economically, the CAR is a country with a population of only 4.8 million, of which more than 70% of the population are living in multidimensional poverty.…”

Section: Resultsmentioning

confidence: 99%

“…Second, although previous studies have demonstrated the important role of community health workers in rapid malaria diagnosis and treatment, the number and training of community health workers remain problematic due to ongoing conflict [ 3 ]. The WHO, the United Nations and the International Committee of the Red Cross (ICRC) have taken active steps.…”

Section: Resultsmentioning

confidence: 99%

Response to COVID-19 in the Central African Republic: Coping Strategies Combined With China’s Experience

Zhu

Xie²,

Li³

et al. 2022

Int J Public Health

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Objectives: The weak health system, domestic political unrest, poverty, and many other factors in the Central African Republic (CAR) have left the country underprepared for the COVID-19 pandemic, resulting in a greater health threat to the entire country. Rapid measures must therefore be taken to prevent the further spread of COVID-19.Methods: This work encompassed a review of relevant literature. We aim to analyze how far Chinese COVID measures can be transferred to the context of the CAR.Results: We argue that the measure that the CAR can learn from China’s success is the involvement of community workers and that greater investment in this model may be the optimal solution. Help from the international community is urgently needed.Conclusion: The CAR can benefit from China’s successful experience in fighting the epidemic, but the disparity in the combined power of the two countries does not allow for simple replication of China’s strategy.

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Primary healthcare delivery models in African conflict-affected settings: a systematic review

Omam

Jarman²,

O’Laughlin

et al. 2023

Confl Health

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Background In conflict-affected settings, access to primary healthcare for displaced populations is constrained by multiple challenges. These include geographical, cultural, communication, logistical and financial barriers, as well as risks posed to health workers and the population by insecurity. Different models of care are used to provide primary healthcare to affected communities. However, there is a paucity of evidence on how these models are selected and implemented by organisations working in conflict and displacement-affected settings. Our aim was to explore the different primary healthcare delivery models used in conflict-affected settings to understand gaps in existing healthcare delivery models. Methods We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The review protocol was registered with the International Prospective Register of Systematic Reviews. We searched six databases for manuscripts published from January 1992 to December 2020. Publications were included if they reported primary healthcare models of care in conflict-affected settings of Africa. Data was analyzed descriptively and thematically using tables, charts and text. Results Forty-eight primary research articles were included for analysis from which thirty-three were rated as “high” quality. The results showed that the models of care in place in these conflict-affected settings include health facility-based, community-based, mobile clinics, outreach and home visits. Primary healthcare for internally displaced persons and refugees is provided by a wide range of actors including national and international organisations. A range of services is offered, most commonly nutrition, mental health and sexual/reproductive health. Some organisations offer vertical (stand-alone) services, while others use an integrated service delivery model. Multiple cadres of healthcare workers provide services, frequently lay healthcare workers such as Community Health Workers. Conclusion Understanding the different modalities of primary healthcare delivery in conflict-affected settings is important to identify existing practices and gaps in service delivery. Service delivery using community health workers in conflict-affected settings is a low-cost primary care delivery strategy that may help optimize contributions of existing personnel through task shifting.

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Evaluation of the effectiveness of community health workers in the fight against malaria in the Central African Republic (2012–2017)

Cited by 7 publications

References 5 publications

The role of community health worker-based care in post-conflict settings: a systematic review

The role of community health worker-based care in post-conflict settings: a systematic review

Response to COVID-19 in the Central African Republic: Coping Strategies Combined With China’s Experience

Primary healthcare delivery models in African conflict-affected settings: a systematic review

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