The Effectiveness of Health Services Delivered by Community Health Workers on Outcomes Related to Non-Communicable Dis-eases among Elderly People in Rural Areas: A Systematic Review
Abstract
Background: The number of elderly and the burden of non-communicable diseases increase with time. Community involvement is expected to be an important prevention agent for their neighbors. This study aimed to determine the effectiveness of health services delivered by community health workers (CHWs) which focus on physiological indices related to non-communicable diseases among elderly people and to explain the health services or interventions carried out by CHWs.
Methods: This systematic review was conducted based on the PRISMA guidelines. PubMed, ProQuest Science Database, Scopus, EBSCOhost CINAHL, and Web of Science were taken as the source of databases. Manual search was also conducted for articles published before March 2019 without time restriction. The quality of each study was assessed using Critical Checklist by Joanna Briggs Institute.
Results: Of the 3,275 initial studies retrieved, 4 studies were included in qualitative synthesis analysis. Three studies arranged a face-to-face interview, while the other study was conducted over the phone. All the 4 studies were intervention studies. Three of them showed a significant improvement in mean systolic blood pressure for the intervention group compared to the control group. The other study showed a significant improvement in weight loss for the intervention group.
Conclusion: Health services delivered by CHWs was beneficial to elderly people in rural areas on some physiological indices. It suggested that health services delivered CHWs could contribute toward secondary prevention programs.
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5. Alwardat N, Di Renzo L, de Miranda RC, et al (2018). Association between hypertension and metabolic disorders among elderly patients in North Jordan. Diabetes Metab Syndr, 12 (5): 661-666.
6. Jeet G, Thakur JS, Prinja S, Singh M (2017). Community health workers for non-communicable diseases prevention and control in developing countries: Evidence and implications. PLoS One, 12 (7): e0180640.
7. Kok MC, Ormel H, Broerse JEW, et al (2017). Optimising the benefits of community health workers ’ unique position between communities and the health sector: A comparative analysis of factors shaping relationships in four countries. Glob Public Health, 12 (11): 1404–32.
8. Rahmawati R, Bajorek B (2015). A community health worker-based program for elderly people with hypertension in Indonesia: A qualitative study. Prev Chronic Dis, 12: E175.
9. Gaziano T, Abrahams-Gessel S, Surka S, et al (2015). Cardiovascular disease screening by community health workers can be cost-effective in low-resource countries. Health Aff (Millwood), 34 (9): 1538–45.
10. Kok MC, Kane SS, Tulloch O, et al (2015). How does context influence performance of community health workers in low- and middle-income countries? Evidence from the literature. Health Res Policy Syst, 13: 13.
11. Mutamba BB, Ginneken N Van, Paintain LS, et al (2013). Roles and effectiveness of lay community health workers in the prevention of mental, neurological and substance use disorders in low and middle income countries: a systematic review. BMC Health Serv Res, 13:412.
12. Duncan MS, Duncan BB (2011). Effectiveness of community health workers in Brazil. J Ambul Care Manag, 34 (4): 326–38.
13. Gogia S, Singh H (2010). Home visits by community health workers to prevent neonatal deaths in developing countries: A systematic review. Bull World Health Organ, 88(9): 658-666B.
14. Lewin S, Munabi‐Babigumira S, Glenton C, et al (2010). Lay health workers in primary and com-munity health care for maternal and child health and the management of infectious diseases. Cochrane Database Syst Rev, 2010(3):CD004015.
15. Gilmore B, Mcauliffe E (2013). Effectiveness of community health workers delivering preventive interventions for maternal and child health in low- and middle-income countries: A systematic review. BMC Public Health, 13:847.
16. Mwai GW, Mburu G, Torpey K, et al (2013). Role and outcomes of community health workers in HIV care in sub-Saharan Africa: A systematic review. J Int AIDS Soc, 16(1):18586.
17. Wells KJ, Luque JS, Miladinovic B, et al (2011). Do community health worker interventions improve rates of screening mammography in the United States? A systematic review. Cancer Epidemiol Biomarkers Prev, 20 (8): 1580–98.
18. Palmas W, March D, Darakjy S, et al (2015). Community health worker interventions to improve glycemic control in people with diabetes: A systematic review and meta-analysis. J Gen Intern Med, 30 (7): 1004–12.
19. Kim K, Choi JS, Choi E, et al (2016). Effects of community-based health worker interventions to improve chronic disease management and care among vulnerable populations: A systematic review. Am J Public Health,106 (4): e3–e28.
20. Moher D, Liberati A, Tetzlaff J, et al (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med, 6 (7): e1000097.
21. Joanna Briggs Institute (2019). Critical Appraisal Tools. https://jbi.global/critical-appraisal-tools
22. Mchugh ML (2012). Lessons in biostatistics interrater reliability: the kappa statistic. Biochem Med (Zagreb), 22(3): 276–82.
23. Tian M, Ajay VS, Dunzhu D, et al (2015). A cluster-randomized, controlled trial of a Simplified Multifaceted Management Program for Individuals at high cardiovascular risk (SimCard trial) in rural Tibet, China, and Haryana, India. Circulation, 132(9): 815–24.
24. O’Neil DS, Lam WC, Nyirangirimana P, et al (2016). Evaluation of care access and hypertension control in a community health worker driven non-communicable disease programme in rural Uganda: the chronic disease in the community project. Health Policy Plan, 31 (7): 878–83.
25. Margolius D, Bodenheimer T, Bennett H, et al (2012). Health coaching to improve hypertension treatment in a low-income, minority population. Ann Fam Med, 10 (3): 199–205.
26. West DS, Bursac Z, Cornell CE, et al (2011). Lay health educators translate a weight-loss intervention in senior centers: a randomized controlled trial. Am J Prev Med, 41 (4): 385–91.
27. Lehmann U, Sanders D (2007). Community health workers: what do we know about them? The state of the evidence on programmes, activities, costs and impact on health outcomes of using community health workers. Geneva: World Health Organization, 1-42.
28. Tulenko K, Møgedal S, Afzal M, et al (2013). Community health workers for universal health-care coverage: from fragmentation to synergy. Bull World Health Organ, 91: 847–52.
29. Bhutta ZA, Lassi ZS, Pariyo G, Huicho L (2010). Global experience of community health workers for delivery of health related millennium devel-opment goals: a systematic review, country case studies, and recommendations for integration in-to national health systems. Global Health Workforce Alliance, file:///C:/Users/Soraya/AppData/Local/Temp/CHW_FullReport_2010.pdf
30. Olaniran A, Smith H, Unkels R, Bar-zeev S (2017). Who is a community health worker? – a systematic review of definitions. Glob Health Action, 10 (1): 1272223.
31. Kowal P, Dowd JE (2001). Definition of an older person. Proposed working definition of an older person in Africa for the MDS Project. World Health Organization, 10 (2.1): 5188-9286.
2. World Health Organization (2019). NCD mortality and morbidity. Available from: https://www.who.int/gho/ncd/mortality_morbidity/en/
3. World Health Organization (2013). Global Health Action For The Prevention And Control Of Noncommunicable Diseases 2013-2020. WHO Document Production Services, Switzerland, pp 3-5.
4. Low W, Lee Y, Samy AL (2015). Non-Communicable Diseases In The Asia-Pacific Region: Prevalence, Risk Factors and Community-Based Prevention. Int J Occup Med Environ Health, 28 (1): 20–6.
5. Alwardat N, Di Renzo L, de Miranda RC, et al (2018). Association between hypertension and metabolic disorders among elderly patients in North Jordan. Diabetes Metab Syndr, 12 (5): 661-666.
6. Jeet G, Thakur JS, Prinja S, Singh M (2017). Community health workers for non-communicable diseases prevention and control in developing countries: Evidence and implications. PLoS One, 12 (7): e0180640.
7. Kok MC, Ormel H, Broerse JEW, et al (2017). Optimising the benefits of community health workers ’ unique position between communities and the health sector: A comparative analysis of factors shaping relationships in four countries. Glob Public Health, 12 (11): 1404–32.
8. Rahmawati R, Bajorek B (2015). A community health worker-based program for elderly people with hypertension in Indonesia: A qualitative study. Prev Chronic Dis, 12: E175.
9. Gaziano T, Abrahams-Gessel S, Surka S, et al (2015). Cardiovascular disease screening by community health workers can be cost-effective in low-resource countries. Health Aff (Millwood), 34 (9): 1538–45.
10. Kok MC, Kane SS, Tulloch O, et al (2015). How does context influence performance of community health workers in low- and middle-income countries? Evidence from the literature. Health Res Policy Syst, 13: 13.
11. Mutamba BB, Ginneken N Van, Paintain LS, et al (2013). Roles and effectiveness of lay community health workers in the prevention of mental, neurological and substance use disorders in low and middle income countries: a systematic review. BMC Health Serv Res, 13:412.
12. Duncan MS, Duncan BB (2011). Effectiveness of community health workers in Brazil. J Ambul Care Manag, 34 (4): 326–38.
13. Gogia S, Singh H (2010). Home visits by community health workers to prevent neonatal deaths in developing countries: A systematic review. Bull World Health Organ, 88(9): 658-666B.
14. Lewin S, Munabi‐Babigumira S, Glenton C, et al (2010). Lay health workers in primary and com-munity health care for maternal and child health and the management of infectious diseases. Cochrane Database Syst Rev, 2010(3):CD004015.
15. Gilmore B, Mcauliffe E (2013). Effectiveness of community health workers delivering preventive interventions for maternal and child health in low- and middle-income countries: A systematic review. BMC Public Health, 13:847.
16. Mwai GW, Mburu G, Torpey K, et al (2013). Role and outcomes of community health workers in HIV care in sub-Saharan Africa: A systematic review. J Int AIDS Soc, 16(1):18586.
17. Wells KJ, Luque JS, Miladinovic B, et al (2011). Do community health worker interventions improve rates of screening mammography in the United States? A systematic review. Cancer Epidemiol Biomarkers Prev, 20 (8): 1580–98.
18. Palmas W, March D, Darakjy S, et al (2015). Community health worker interventions to improve glycemic control in people with diabetes: A systematic review and meta-analysis. J Gen Intern Med, 30 (7): 1004–12.
19. Kim K, Choi JS, Choi E, et al (2016). Effects of community-based health worker interventions to improve chronic disease management and care among vulnerable populations: A systematic review. Am J Public Health,106 (4): e3–e28.
20. Moher D, Liberati A, Tetzlaff J, et al (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med, 6 (7): e1000097.
21. Joanna Briggs Institute (2019). Critical Appraisal Tools. https://jbi.global/critical-appraisal-tools
22. Mchugh ML (2012). Lessons in biostatistics interrater reliability: the kappa statistic. Biochem Med (Zagreb), 22(3): 276–82.
23. Tian M, Ajay VS, Dunzhu D, et al (2015). A cluster-randomized, controlled trial of a Simplified Multifaceted Management Program for Individuals at high cardiovascular risk (SimCard trial) in rural Tibet, China, and Haryana, India. Circulation, 132(9): 815–24.
24. O’Neil DS, Lam WC, Nyirangirimana P, et al (2016). Evaluation of care access and hypertension control in a community health worker driven non-communicable disease programme in rural Uganda: the chronic disease in the community project. Health Policy Plan, 31 (7): 878–83.
25. Margolius D, Bodenheimer T, Bennett H, et al (2012). Health coaching to improve hypertension treatment in a low-income, minority population. Ann Fam Med, 10 (3): 199–205.
26. West DS, Bursac Z, Cornell CE, et al (2011). Lay health educators translate a weight-loss intervention in senior centers: a randomized controlled trial. Am J Prev Med, 41 (4): 385–91.
27. Lehmann U, Sanders D (2007). Community health workers: what do we know about them? The state of the evidence on programmes, activities, costs and impact on health outcomes of using community health workers. Geneva: World Health Organization, 1-42.
28. Tulenko K, Møgedal S, Afzal M, et al (2013). Community health workers for universal health-care coverage: from fragmentation to synergy. Bull World Health Organ, 91: 847–52.
29. Bhutta ZA, Lassi ZS, Pariyo G, Huicho L (2010). Global experience of community health workers for delivery of health related millennium devel-opment goals: a systematic review, country case studies, and recommendations for integration in-to national health systems. Global Health Workforce Alliance, file:///C:/Users/Soraya/AppData/Local/Temp/CHW_FullReport_2010.pdf
30. Olaniran A, Smith H, Unkels R, Bar-zeev S (2017). Who is a community health worker? – a systematic review of definitions. Glob Health Action, 10 (1): 1272223.
31. Kowal P, Dowd JE (2001). Definition of an older person. Proposed working definition of an older person in Africa for the MDS Project. World Health Organization, 10 (2.1): 5188-9286.
| Files | ||
| Issue | Vol 50 No 6 (2021) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v50i6.6408 | |
| Keywords | ||
| Elderly Lay health workers Non-communicable disease Remote area Physiological index | ||
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How to Cite
1.
Widyasari V, Rahman F, Lin K-H, Wang J-Y. The Effectiveness of Health Services Delivered by Community Health Workers on Outcomes Related to Non-Communicable Dis-eases among Elderly People in Rural Areas: A Systematic Review. Iran J Public Health. 2021;50(6):1088-1096.
