Skip to main content
Top
Published in: Globalization and Health 1/2015

Open Access 01-12-2015 | Commentary

Mitigation of non-communicable diseases in developing countries with community health workers

Authors: Shiva Raj Mishra, Dinesh Neupane, David Preen, Per Kallestrup, Henry B. Perry

Published in: Globalization and Health | Issue 1/2015

Login to get access

Abstract

Non-communicable diseases (NCDs) are rapidly becoming priorities in developing countries. While developed countries are more prepared in terms of skilled human resources for NCD management, developing the required human resources is still a challenge in developing countries. In this context, mobilizing community health workers (CHWs) for control of NCDs seems promising. With proper training, supervision and logistical support, CHWs can participate in the detection and treatment of hypertension, diabetes, and other priority chronic diseases. Furthermore, advice and support that CHWs can provide about diet, physical activity, and other healthy lifestyle habits (such as avoidance of smoking and excessive alcohol intake) have the potential for contributing importantly to NCD programs. This paper explores the possibility of involving CHWs in developing countries for addressing NCDs.
Literature
2.
go back to reference Bloom DE, Cafiero E, Jané-Llopis E, Abrahams-Gessel S, Bloom LR, Fathima S, et al. The global economic burden of noncommunicable diseases. In: World Economic Forum, Harvard School of Public Health. Geneva: 2012. Bloom DE, Cafiero E, Jané-Llopis E, Abrahams-Gessel S, Bloom LR, Fathima S, et al. The global economic burden of noncommunicable diseases. In: World Economic Forum, Harvard School of Public Health. Geneva: 2012.
4.
go back to reference Maher D, Ford N, Unwin N. Priorities for developing countries in the global response to non-communicable diseases. Glob Health. 2012;8:14.CrossRef Maher D, Ford N, Unwin N. Priorities for developing countries in the global response to non-communicable diseases. Glob Health. 2012;8:14.CrossRef
5.
go back to reference Amine E, Baba N, Belhadj M, Deurenbery-Yap M, Djazayery A, Forrester T, et al. Diet, nutrition and the prevention of chronic diseases: report of a Joint WHO/FAO Expert Consultation. Geneva. World Health Organization; 2002. Amine E, Baba N, Belhadj M, Deurenbery-Yap M, Djazayery A, Forrester T, et al. Diet, nutrition and the prevention of chronic diseases: report of a Joint WHO/FAO Expert Consultation. Geneva. World Health Organization; 2002.
6.
go back to reference Mendis S. The policy agenda for prevention and control of non-communicable diseases. Br Med Bull. 2010;96:23–43. ldq037.CrossRefPubMed Mendis S. The policy agenda for prevention and control of non-communicable diseases. Br Med Bull. 2010;96:23–43. ldq037.CrossRefPubMed
7.
go back to reference Wang S, Marquez P, Langenbrunner J. Toward a healthy and harmonious life in China: stemming the rising tide of non-communicable diseases. Washington: The World Bank; 2011. Wang S, Marquez P, Langenbrunner J. Toward a healthy and harmonious life in China: stemming the rising tide of non-communicable diseases. Washington: The World Bank; 2011.
8.
go back to reference Samb B, Desai N, Nishtar S, Mendis S, Bekedam H, Wright A, et al. Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries. Lancet. 2010;376(9754):1785–97.CrossRefPubMed Samb B, Desai N, Nishtar S, Mendis S, Bekedam H, Wright A, et al. Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries. Lancet. 2010;376(9754):1785–97.CrossRefPubMed
9.
go back to reference Perry HB, Zulliger R, Rogers MM. Community health workers in low-, middle-, and high-income countries: an overview of their history, recent evolution, and current effectiveness. Annu Rev Public Health. 2014;35:399–421.CrossRefPubMed Perry HB, Zulliger R, Rogers MM. Community health workers in low-, middle-, and high-income countries: an overview of their history, recent evolution, and current effectiveness. Annu Rev Public Health. 2014;35:399–421.CrossRefPubMed
11.
go back to reference Perry H, Scott K, Javadi D, Gergen J, Shelley K, Crigler L, et al. Case Studies of Large-Scale Community Health Worker Programs: Examples from Afghanistan, Bangladesh, Brazil, Ethiopia, India, Indonesia, Iran, Nepal, Pakistan, Rwanda, Zambia, and Zimbabwe. In: Perry H, Crigler L, editors. Developing and strengthening community health worker programs at scale: a reference guide and case studies for program managers and policy makers. Washington, DC: USAID/MCHIP; 2014. http://www.mchip.net/sites/default/files/MCHIP_CHW%20Ref%20Guide.pdf. Perry H, Scott K, Javadi D, Gergen J, Shelley K, Crigler L, et al. Case Studies of Large-Scale Community Health Worker Programs: Examples from Afghanistan, Bangladesh, Brazil, Ethiopia, India, Indonesia, Iran, Nepal, Pakistan, Rwanda, Zambia, and Zimbabwe. In: Perry H, Crigler L, editors. Developing and strengthening community health worker programs at scale: a reference guide and case studies for program managers and policy makers. Washington, DC: USAID/MCHIP; 2014. http://​www.​mchip.​net/​sites/​default/​files/​MCHIP_​CHW%20​Ref%20​Guide.​pdf.
12.
go back to reference Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, et al. Human resources for health: overcoming the crisis. Lancet. 2004;364(9449):1984–90.CrossRefPubMed Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, et al. Human resources for health: overcoming the crisis. Lancet. 2004;364(9449):1984–90.CrossRefPubMed
13.
go back to reference Singh P, Chokshi DA. Community health workers--a local solution to a global problem. N Engl J Med. 2013;369(10):894–6.CrossRefPubMed Singh P, Chokshi DA. Community health workers--a local solution to a global problem. N Engl J Med. 2013;369(10):894–6.CrossRefPubMed
15.
go back to reference Dawson AJ, Buchan J, Duffield C, Homer CS, Wijewardena K. Task shifting and sharing in maternal and reproductive health in low-income countries: a narrative synthesis of current evidence. Health Policy Plan. 2014;29(3):396–408.CrossRefPubMed Dawson AJ, Buchan J, Duffield C, Homer CS, Wijewardena K. Task shifting and sharing in maternal and reproductive health in low-income countries: a narrative synthesis of current evidence. Health Policy Plan. 2014;29(3):396–408.CrossRefPubMed
16.
go back to reference Joshi R, Alim M, Kengne AP, Jan S, Maulik PK, Peiris D, et al. Task shifting for non-communicable disease management in low and middle income countries--a systematic review. PLoS One. 2014;9(8):e103754.PubMedCentralCrossRefPubMed Joshi R, Alim M, Kengne AP, Jan S, Maulik PK, Peiris D, et al. Task shifting for non-communicable disease management in low and middle income countries--a systematic review. PLoS One. 2014;9(8):e103754.PubMedCentralCrossRefPubMed
17.
go back to reference World Health Organization. Treat train retain. Task shifting: global recommendations and guidelines. Geneva: WHO; 2007. World Health Organization. Treat train retain. Task shifting: global recommendations and guidelines. Geneva: WHO; 2007.
18.
go back to reference World Health Organization: Mental Health Gap Action Programme: MhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-specialized Health Settings: Version 1.0. Geneva: WHO. 2010. World Health Organization: Mental Health Gap Action Programme: MhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-specialized Health Settings: Version 1.0. Geneva: WHO. 2010.
19.
go back to reference Farzadfar F, Murray CJ, Gakidou E, Bossert T, Namdaritabar H, Alikhani S, et al. Effectiveness of diabetes and hypertension management by rural primary health-care workers (Behvarz workers) in Iran: a nationally representative observational study. Lancet. 2012;379(9810):47–54.CrossRefPubMed Farzadfar F, Murray CJ, Gakidou E, Bossert T, Namdaritabar H, Alikhani S, et al. Effectiveness of diabetes and hypertension management by rural primary health-care workers (Behvarz workers) in Iran: a nationally representative observational study. Lancet. 2012;379(9810):47–54.CrossRefPubMed
20.
go back to reference Jafar TH, Islam M, Hatcher J, Hashmi S, Bux R, Khan A, et al. Community based lifestyle intervention for blood pressure reduction in children and young adults in developing country: cluster randomised controlled trial. BMJ. 2010;340:c2641.PubMedCentralCrossRefPubMed Jafar TH, Islam M, Hatcher J, Hashmi S, Bux R, Khan A, et al. Community based lifestyle intervention for blood pressure reduction in children and young adults in developing country: cluster randomised controlled trial. BMJ. 2010;340:c2641.PubMedCentralCrossRefPubMed
21.
go back to reference Jafar TH, Islam M, Bux R, Poulter N, Hatcher J, Chaturvedi N, et al. Cost-effectiveness of community-based strategies for blood pressure control in a low-income developing country: findings from a cluster-randomized, factorial-controlled trial. Circulation. 2011;124(15):1615–25.PubMedCentralCrossRefPubMed Jafar TH, Islam M, Bux R, Poulter N, Hatcher J, Chaturvedi N, et al. Cost-effectiveness of community-based strategies for blood pressure control in a low-income developing country: findings from a cluster-randomized, factorial-controlled trial. Circulation. 2011;124(15):1615–25.PubMedCentralCrossRefPubMed
22.
go back to reference McPake B, Edoka I, Witter S, Kielmann K, Taegtmeyer M, Dieleman M, et al. Cost–effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya. Bull World Health Organ. 2015;93:631–639A.PubMedCentralCrossRefPubMed McPake B, Edoka I, Witter S, Kielmann K, Taegtmeyer M, Dieleman M, et al. Cost–effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya. Bull World Health Organ. 2015;93:631–639A.PubMedCentralCrossRefPubMed
23.
go back to reference Pearson T, Wall S, Lewis C, Jenkins P, Nafziger A, Weinehall L. Dissecting the “black box” of community intervention: Lessons from community-wide cardiovascular disease prevention programs in the US and Sweden. Scand J Public Health. 2001;29(56 suppl):69–78. Pearson T, Wall S, Lewis C, Jenkins P, Nafziger A, Weinehall L. Dissecting the “black box” of community intervention: Lessons from community-wide cardiovascular disease prevention programs in the US and Sweden. Scand J Public Health. 2001;29(56 suppl):69–78.
24.
go back to reference Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, et al. Priority actions for the non-communicable disease crisis. Lancet. 2011;377(9775):1438–47.CrossRefPubMed Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, et al. Priority actions for the non-communicable disease crisis. Lancet. 2011;377(9775):1438–47.CrossRefPubMed
25.
go back to reference Deressa W, Azazh A. Attitudes of undergraduate medical students of Addis Ababa University towards medical practice and migration, Ethiopia. BMC Med Educ. 2012;12:68.PubMedCentralCrossRefPubMed Deressa W, Azazh A. Attitudes of undergraduate medical students of Addis Ababa University towards medical practice and migration, Ethiopia. BMC Med Educ. 2012;12:68.PubMedCentralCrossRefPubMed
26.
go back to reference Saini NK, Sharma R, Roy R, Verma R. What impedes working in rural areas? A study of aspiring doctors in the National Capital Region. India Rural and remote health. 2012;12:1967.PubMed Saini NK, Sharma R, Roy R, Verma R. What impedes working in rural areas? A study of aspiring doctors in the National Capital Region. India Rural and remote health. 2012;12:1967.PubMed
27.
go back to reference Lewin S, Munabi-Babigumira S, Glenton C, Daniels K, Bosch-Capblanch X, van Wyk BE, et al. Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases. Cochrane Database Syst Rev. 2010;3:CD004015.PubMed Lewin S, Munabi-Babigumira S, Glenton C, Daniels K, Bosch-Capblanch X, van Wyk BE, et al. Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases. Cochrane Database Syst Rev. 2010;3:CD004015.PubMed
28.
go back to reference Christopher JB, Le May A, Lewin S, Ross DA. Thirty years after Alma-Ata: a systematic review of the impact of community health workers delivering curative interventions against malaria, pneumonia and diarrhoea on child mortality and morbidity in sub-Saharan Africa. Hum Resour Health. 2011;9(1):27.PubMedCentralCrossRefPubMed Christopher JB, Le May A, Lewin S, Ross DA. Thirty years after Alma-Ata: a systematic review of the impact of community health workers delivering curative interventions against malaria, pneumonia and diarrhoea on child mortality and morbidity in sub-Saharan Africa. Hum Resour Health. 2011;9(1):27.PubMedCentralCrossRefPubMed
29.
go back to reference Brown 3rd HS, Wilson KJ, Pagan JA, Arcari CM, Martinez M, Smith K, et al. Cost-effectiveness analysis of a community health worker intervention for low-income Hispanic adults with diabetes. Prev Chronic Dis. 2012;9:E140.PubMedCentralCrossRefPubMed Brown 3rd HS, Wilson KJ, Pagan JA, Arcari CM, Martinez M, Smith K, et al. Cost-effectiveness analysis of a community health worker intervention for low-income Hispanic adults with diabetes. Prev Chronic Dis. 2012;9:E140.PubMedCentralCrossRefPubMed
30.
go back to reference Olsen L, Young PL. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. In: Institute of Medicine (US) Roundtable on Evidence-Based Medicine. Washington: National Academies Press; 2010. Olsen L, Young PL. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. In: Institute of Medicine (US) Roundtable on Evidence-Based Medicine. Washington: National Academies Press; 2010.
32.
go back to reference Edward A, Ernst P, Taylor C, Becker S, Mazive E, Perry H. Examining the evidence of under-five mortality reduction in a community-based programme in Gaza, Mozambique. Trans R Soc Trop Med Hyg. 2007;101(8):814–22.CrossRefPubMed Edward A, Ernst P, Taylor C, Becker S, Mazive E, Perry H. Examining the evidence of under-five mortality reduction in a community-based programme in Gaza, Mozambique. Trans R Soc Trop Med Hyg. 2007;101(8):814–22.CrossRefPubMed
33.
go back to reference Davis TP, Wetzel C, Hernandez Avilan E, de Mendoza LC, Chase RP, Winch PJ, et al. Reducing child global undernutrition at scale in Sofala Province, Mozambique, using Care Group Volunteers to communicate health messages to mothers. Global Health: Science and Practice. 2013;1(1):35–51. Davis TP, Wetzel C, Hernandez Avilan E, de Mendoza LC, Chase RP, Winch PJ, et al. Reducing child global undernutrition at scale in Sofala Province, Mozambique, using Care Group Volunteers to communicate health messages to mothers. Global Health: Science and Practice. 2013;1(1):35–51.
34.
go back to reference Prost A, Colbourn T, Seward N, Azad K, Coomarasamy A, Copas A, et al. Women’s groups practising participatory learning and action to improve maternal and newborn health in low-resource settings: a systematic review and meta-analysis. Lancet. 2013;381(9879):1736–46.PubMedCentralCrossRefPubMed Prost A, Colbourn T, Seward N, Azad K, Coomarasamy A, Copas A, et al. Women’s groups practising participatory learning and action to improve maternal and newborn health in low-resource settings: a systematic review and meta-analysis. Lancet. 2013;381(9879):1736–46.PubMedCentralCrossRefPubMed
35.
go back to reference Mohan V, Deepa R, Deepa M, Somannavar S, Datta M. A simplified Indian Diabetes Risk Score for screening for undiagnosed diabetic subjects. J Assoc Physicians India. 2005;53:759–63.PubMed Mohan V, Deepa R, Deepa M, Somannavar S, Datta M. A simplified Indian Diabetes Risk Score for screening for undiagnosed diabetic subjects. J Assoc Physicians India. 2005;53:759–63.PubMed
36.
go back to reference Buttorff C, Hock RS, Weiss HA, Naik S, Araya R, Kirkwood BR, et al. Economic evaluation of a task-shifting intervention for common mental disorders in India. Bull World Health Organ. 2012;90(11):813–21.PubMedCentralCrossRefPubMed Buttorff C, Hock RS, Weiss HA, Naik S, Araya R, Kirkwood BR, et al. Economic evaluation of a task-shifting intervention for common mental disorders in India. Bull World Health Organ. 2012;90(11):813–21.PubMedCentralCrossRefPubMed
37.
go back to reference Perry H, Crigler L. Developing and strengthening community health worker programs at scale. A reference guide and case studies for program managers and policymakers. In: Maternal and Child Health Integrated Program, Jhpiego; 2013. Perry H, Crigler L. Developing and strengthening community health worker programs at scale. A reference guide and case studies for program managers and policymakers. In: Maternal and Child Health Integrated Program, Jhpiego; 2013.
38.
go back to reference Bennett S, George A, Rodriguez D, Shearer J, Diallo B, Konate M, et al. Policy challenges facing integrated community case management in Sub‐Saharan Africa. Trop Med Int Health. 2014;19(7):872–82.PubMedCentralCrossRefPubMed Bennett S, George A, Rodriguez D, Shearer J, Diallo B, Konate M, et al. Policy challenges facing integrated community case management in Sub‐Saharan Africa. Trop Med Int Health. 2014;19(7):872–82.PubMedCentralCrossRefPubMed
39.
go back to reference Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, et al. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117–71. Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, et al. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117–71.
40.
go back to reference Neupane D, Kallestrup P, McLachlan CS, Perry H. Community health workers for non-communicable diseases. The Lancet Global health. 2014;2(10):e567.CrossRefPubMed Neupane D, Kallestrup P, McLachlan CS, Perry H. Community health workers for non-communicable diseases. The Lancet Global health. 2014;2(10):e567.CrossRefPubMed
Metadata
Title
Mitigation of non-communicable diseases in developing countries with community health workers
Authors
Shiva Raj Mishra
Dinesh Neupane
David Preen
Per Kallestrup
Henry B. Perry
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Globalization and Health / Issue 1/2015
Electronic ISSN: 1744-8603
DOI
https://doi.org/10.1186/s12992-015-0129-5

Other articles of this Issue 1/2015

Globalization and Health 1/2015 Go to the issue