Non-communicable diseases in sub-Saharan Africa: a scoping review of large cohort studies

Non-communicable diseases (NCDs) cause a large and growing burden of morbidity and mortality in sub-Saharan Africa. Prospective cohort studies are key to study multiple risk factors and chronic diseases and are crucial to our understanding of the burden, aetiology and prognosis of NCDs in SSA. The aim of this study was to identify the level of research output on NCDs and their risk factors collected by cohorts in SSA.

Community Health Workers Improve Linkage to Hypertension Care in Western Kenya

Elevated blood pressure (BP) is the leading global risk factor for mortality. Delay in seeking hypertension care is associated with increased mortality.

The aim of this study investigated whether community health workers, equipped with behavioral communication strategies and smartphone technology, can increase linkage of individuals with elevated BP to a hypertension care program in western Kenya and significantly reduce BP.

A qualitative appraisal of stakeholders’ perspectives of a community-based primary health care program in rural Ghana

The Ghana Community-based Health Planning and Services (CHPS) initiative is a national strategy for improving access to primary health care services for underserved communities. Following a successful trial in the North Eastern part of the country, CHPS was adopted as Ghana’s flagship programme for achieving the Universal Health Coverage. Recent empirical evidence suggests, however, that scale-up of CHPS has not necessarily replicated the successes of the pilot study. This study examines the community’s perspective of the performance of CHPS and how the scale up could potentially align with the original experimental study.

Integrating services for impact and sustainability: a proof-of-concept project in KwaZulu-Natal, South Africa

Integration of services in primary health care settings can provide mother/baby pairs with all required services at one visit. This study aimed to evaluate a proof of concept, quality improvement (QI) intervention to strengthen well-child service provision and integration with maternal health services in five rural clinics in KwaZulu-Natal, South Africa.

Ghana country assessment report on ageing and health

Ghana, like many other countries, is experiencing a demographic transition with its ageing population. To provide reliable evidence for policy-making in ageing and health, this assessment report is prepared to identify priority issues on ageing in Ghana. By reviewing evidence from the WHO Study on global AGEing and adult health (SAGE) in Ghana and other sources, this document reveals the health status of older people in Ghana as well as the health systems response and policies relevant to ageing. The report also proposed 5 priorities relating to the prevention, treatment and care needs of older people in Ghana.

Strengthening national health research systems in the WHO African Region – progress towards universal health coverage

Health challenges and health systems set-ups differ, warranting contextualised healthcare interventions to move towards universal health coverage. As such, there is emphasis on generation of contextualized evidence to solve local challenges. However, weak research capacity and inadequate resources remain an impendiment to quality research in the African region. WHO African Region (WHO AFRO) facilitated the adoption of a regional strategy for strengthening national health research systems (NHRS) in 2015. This article assessed the progress in strengthening NHRS among the 47 member states of the WHO AFRO.

Community health extension program of Ethiopia, 2003–2018: successes and challenges toward universal coverage for primary healthcare services

The Alma-Ata Declaration of 1978 identified primary health care (PHC) as the key approach to the attainment of the goal of “Health for All”. The PHC approach tackles the main health problems in the community through the provision of essential health services. The implementation of the PHC approach relies on health workers, including community health workers (CHWs) Ethiopia has been implementing a community health extension program (HEP) since 2003. The aim of this studya was to assess the successes and challenges of the HEP over time, and develop a framework that may assist the implementation of the program toward universal ...

The Governance of National Community Health Worker Programmes in Low- and Middle-Income Countries: An Empirically Based Framework of Governance Principles, Purposes and Tasks

National community health worker (CHW) programmes are increasingly regarded as an integral component of primary healthcare (PHC) in low- and middle-income countries (LMICs). At the interface of the formal health system and communities, CHW programmes evolve in context specific ways, with unique cadres and a variety of vertical and horizontal relationships. These programmes need to be appropriately governed if they are to succeed, yet there is little evidence or guidance on what this entails in practice. Based on empirical observations of South Africa’s community-based health sector and informed by theoretical insights on governance, this paper proposes a practical framework ...

Does supportive supervision enhance community health worker motivation? A mixed-methods study in four African countries

Supportive supervision is an important element of community health worker (CHW) programmes and is believed to improve CHW motivation and performance. A group supervision intervention, which included training and mentorship of supervisors, was implemented in Ethiopia, Kenya, Malawi and Mozambique. In three of the countries, this was combined with individual and/or peer supervision. A mixed-methods implementation study was conducted to assess the effect of the supervision intervention on CHWs’ perceptions of supervision and CHW motivation-related outcomes. The study suggests that there is potential for integrating supportive group supervision models in CHW programmes. A combination of group with individual or ...

Universal health coverage necessitates a system approach: an analysis of Community-based Health Planning and Services (CHPS) initiative in Ghana

The 9th Global conference on health promotion (Shanghai 2016) reaffirmed the role of primary health care (PHC) in achieving the 2030 Sustainable Development Agenda. Gaining much international recognition, the community-based health planning and services (CHPS) initiative is considered one of the pragmatic strategy in delivering on the promise of universal health coverage (UHC) through the PHC strategy, in Ghana. Yet, certain key factors threaten its successes – renewing the relevance of this study to present the barriers to and facilitators of the initiative. According to their findings, CHPS contribution particularly in bridging geographical access to health cannot be demeaned. Nevertheless, the ...