Background
Methods
Results
Description of the selected studies
No | Citation | Country | Study design | Intervention | Cadre |
---|---|---|---|---|---|
1. | Rodriguez et al. [20] | Malawi | Case study | iCCM | Health surveillance assistants |
2. | Chilundo et al. [21] | Mozambique | Qualitative study | iCCM | CHWs |
3. | Yansaneh et al. [33] | Sierra Leone | Mixed methods: household survey, in-depth interviews, focus group discussions | Free healthcare initiative and iCCM | CHVs |
4. | Witek-McManus et al. [34] | Malawi | Pre-post interventional study | Training programme for school teachers | CHWs |
5. | Nanyonjo et al. [30] | Uganda | Cross-sectional study | iCCM | CHWs |
6. | Heidkamp et al. [26] | Malawi | Cross-sectional study | iCCM | CHWs, called health surveillance assistants |
7. | Linn et al. [19] | Senegal | Quasi-experimental study | ProAct model (iCCM in which CHWs proactively search for cases) | HCPs |
8. | Druetz et al. [35] | Burkina Faso | Cross-sectional study | Community case management of malaria | CHWs |
9. | Das et al. [36] | India | Pre-post interventional study | a. Supportive supervision of ASHA plus community mobilization b. Community mobilization only | ASHA |
10. | Yansaneh et al. [12] | Sierra Leone | Pre-post interventional study | Health for the poorest quintile, focussing on 3 diseases: diarrhoea, malaria, pneumonia. | CHWs |
11. | Banek et al. [13] | Uganda | Mixed methods: cross-sectional, qualitative design | Home-base management of fever | CMDs |
12. | Hamainza et al. [22] | Zambia | Longitudinal study | CHWs providing passive and active visits to households | CHWs |
13. | Abbey et al. [24] | Ghana | Mixed method: cross-sectional, qualitative design | Community-based health intervention | CHWs |
14. | Lwin et al. [37] | Myanmar | Community-base intervention study | Sun primary health community-based intervention | CHWs |
15. | Tine et al. [14] | Senegal | Randomized controlled trial | CCMm and seasonal malaria chemoprevention | CHWs |
16. | Tine et al. [29] | Senegal | Randomized controlled trial | Home-based management of malaria using RDT, ACT, rectal artesunate seasonal malaria chemoprevention delivered by CHWs | CHWs |
17. | Nanyonjo et al. [18] | Uganda | Cross-sectional study | iCCM | CHWs:
Primary health facility workers (PFHWs)
|
18. | Siekmans et al. [38] | Kenya | Cross-sectional study | iCCM | CHWs |
19. | Ndiaye et al. [39] | Senegal | Secondary data analysis | CCMm | CHWs |
20. | Blanas et al. [28] | Senegal | Mixed-methods design | CCMm | CHWs |
21. | Ohnmar et al. [40] | Myanmar | Randomized controlled trial | Training unpaid village volunteers in provision of RDT, ACT and supervision | Village volunteers |
22. | Lim et al. [41] | Cambodia | Cross-sectional study | VMW vs health facility health worker intervention | VMW |
23. | Kisia et al. [42] | Kenya | Cross-sectional study | CCMm | CHWs |
24. | Counihan et al. [25] | Zambia | Longitudinal study | CHW intervention | CHWs |
25. | Rutta et al. [43] | Tanzania | Pre-post intervention study | CORPs to provide early diagnosis and treatment of malaria | CORPs |
26. | Ratsimbasoa et al. [44] | Madagascar | Mixed methods design | RDTs conducted by CHWs, compared to PCR and microscopy | CHWs |
27. | Brenner et al. [23] | Uganda | Pre-post intervention study | Volunteer community health worker intervention | Community health volunteers |
28. | Mukanga et al. [45] | Uganda | Qualitative study | Integrated malaria and pneumonia community case management | CHWs |
29. | Thiam et al. [46] | Senegal | Secondary data analysis | Home-based management of malaria | HCPs |
30. | Okeibunor et al. [15] | Nigeria | Pre-post intervention study | VCDDs intervention | VCDD |
31. | Lemma et al. [47] | Ethiopia | Pre-post intervention study | Training of CHWs | CHWs |
32. | Patouillard et al. [16] | Ghana | Randomized controlled trial | Intermittent preventive treatment of malaria in children (IPTc) | Community health volunteers |
33. | Chanda et al. [48] | Zambia | Cross-sectional study | HMM | CHWs |
34. | Chanda et al. [49] | Zambia | Prospective study | CHWs intervention | CHWs |
35 | Ngasala et al. [50] | Tanzania | Prospective study | Delivery of artemether–lumefantrine by community health workers | CHWs |
36. | Phommanivong et al. [51] | Lao PDR | Prospective study | Training of village health volunteers | Village health workers |
37. | Yeboah-Antwi et al. [52] | Zambia | Cluster randomized controlled trial | CHW intervention | CHWs |
38. | Mukanga et al. [53] | Uganda | Qualitative study | CHW intervention | CMDs |
39. | Yasuoka et al. [17] | Cambodia | Cross-sectional study | VMW intervention | VMW |
40. | Hawkes et al. [54] | Democratic Republic of Congo | Prospective cohort study | Training of CHWs | CHWs |
41. | Eke et al. [55] | Nigeria | Prospective cohort study | CHW intervention | CHWs |
42. | Awor et al. [56] | Uganda | Quasi-experimental study | iCCM | Drug shop attendants |
43. | Cox et al. [57] | Cambodia | Mixed methods study | Community-based surveillance systems | VMW |
44. | Hamainza et al. [22] | Zambia | Cross-sectional study | Mobile phone SMS vs register book | CHWs |
45. | Ndiaye et al. [58] | Senegal | Prospective cohort study | Paediatric kit containing quinine, purified water, syringe | CHWs |
46. | Das et al. [59] | India | Longitudinal study | Community-based presumptive chloroquine treatment | Volunteers |
47. | Mbonye et al. [60] | Uganda | Intervention study | Community-based IPTp | Drug shop vendors, traditional birth attendants, community reproductive health worker, adolescent peer mobilizer |
48. | Vanek et al. [61] | Tanzania | Cross-sectional study | Community-based surveillance | CORPs |
49. | Cho-Min-Naing et al. [62] | Myanmar | Cross-sectional study | Rapid on-site immunochromatographic test | Volunteer health workers |
50. | Kelly et al. [63] | Kenya | Cross-sectional study | Community initiatives for child survival | CHWs |
51. | Ruebush et al. [64] | Guatemala | Intervention study | Community-based malaria case detection system—Volunteer collaboration network (VCN) | Volunteer collaborators |
52. | Aung et al. [65] | Myanmar | Pre-post intervention study | Training of CHWs | CHWs |
53. | Gidebo et al. [66] | Ethiopia | Mixed-methods study | Health extension programme | CHWs |
54. | Kalyango et al. [67] | Uganda | Mixed methods study | iCCM of childhood illnesses | CHWs |
55. | Hamer et al. [68] | Zambia | Cluster randomized controlled trial | Training of CHWs | CHWs |
56. | Mubi et al. [10] | Tanzania | Randomized cross-over trial | Training of CHWs | CHWs |
57. | Harvey et al. [69] | Zambia | Quasi-experimental study | Training of CHWs | CHWs |
58. | Delacollette et al. [70] | Zaire | Prospective cohort study | Training of CHWs | CHWs |
59. | Eriksen et al. [71] | Tanzania | Randomized controlled trial | Training of community women leaders | Women leaders |
60. | Kouyaté et al. [72] | Burkina Faso | Randomized controlled trial | Training of women group leaders by health workers | Lay community women leaders |
61. | Onwujekwe et al. [73] | Nigeria | Prospective study | Training of CHWs | CHWs |
62. | Mayxay et al. [74] | Laos PDR | Longitudinal study | Training of VHVs | VHVs |
63. | Hii et al. [75] | Malaysia | Cross-sectional study | Community participation health programme (Sukarelawan Penjagaan Kesihatan Primer (SPKP)) | VHVs |
64. | Spencer et al. [76] | Kenya | Cross-sectional study | Community-based malaria control programme | Volunteer community health workers |
65. | Ajayi et al. [77] | Nigeria | Pre-post intervention study | Training of mother trainers | CHWs |
66. | Kweku et al. [78] | Ghana | Randomized controlled trial | IPTc | Community volunteers vs health workers in health facilities |
Role of CHWs and related cadres in malaria interventions
SN | Citation | Cadre | Roles |
---|---|---|---|
1. | Rodriguez et al. [20] | Health surveillance assistants | Treatment with ACT Disease surveillance Health promotion |
2. | Chilundo et al. [21] | CHWs:
Agentes Polivalentes Elementares (APEs)
| Prescription of anti-malarial Management of malaria cases |
3. | Yansaneh et al. [33] | Community health volunteers | Malaria treatment Health promotion Referral of critical patients or those with danger signs Accompanies malaria-sick patients to health facilities |
4. | Witek-McManus et al. [34] | CHWs | Diagnosis using RDT Treatment using ACT |
5. | Nanyonjo et al. [30] | CHWs | Diagnosis Patients’ referral |
6. | Linn et al. [19] | HCPs | Home visitation and health promotion |
7. | Druetz et al. [35] | CHWs | Patients consultations Prescription and treatment |
8. | Das et al. [36] | ASHA | Patients consultations Prescription and treatment |
9. | Yansaneh et al. [12] | Community health volunteers | Malaria treatment Disease prevention |
10. | Banek et al. [13] | (CMDs) | Home-based treatment of malaria |
11. | Hamainza et al. [22] | CHWs | Malaria treatment Diagnosis using RDT |
12. | Abbey et al. [24] | CHWs | Health promotion |
13. | Tine et al. [14] | CHWs | Malaria treatment Health promotion |
14. | Tine et al. [29] | CHWs | Home-based treatment and diagnosis |
15. | Nanyonjo et al. [18] | Primary health facility workers (PFHWs) | Facility treatment Health promotion and prevention |
16. | Siekmans et al. [38] | CHWs | Home-based treatment and diagnosis |
17. | Ndiaye et al. [39] | CHWs | Consultations Treatment using ACT Patients’ referrals Diagnosis using RDT |
18. | Blanas et al. [28] | CHWs | Treatment and prescription of ACT Diagnosis with RDT Selling anti-malarials at government prices |
19. | Ohnmar et al. [40] | Village volunteers | Treatment and prescription of ACT Diagnosis with RDT |
20. | Lim et al. [41] | Village malaria workers | Diagnosis |
21. | Kisia et al. [42] | CHWs | Treatment and prescription of ACT |
22. | Counihan et al. [25] | CHWs | Diagnosis using RDT |
23. | Rutta et al. [43] | CORPs | Diagnosis using RDT Treatment using ACT Referral of malaria cases |
24. | Ratsimbasoa et al. [44] | CHWs | Diagnosis using RDT |
25. | Brenner et al. [23] | Community health volunteers | Diagnosis using RDT Treatment using ACT |
26. | Mukanga et al. [45] | CHWs | Patients’ consultation: taking history Diagnosis with RDT Patient’s classification |
27. | Thiam et al. [46] | HCPs | Patients’ consultation: taking history Diagnosis with RDT Treatment |
28. | Okeibunor et al. [15] | CDDs | Distribution of ITNs Provision of IPTp drugs Counselling services on prevention among pregnant women |
29. | Lemma et al. [47] | CHWs | Diagnosis using RDT Treatment of malaria |
30. | Patouillard et al. [16] | Community health volunteers | Intermittent preventive treatment in children (IPTc) |
31. | Chanda et al. [48] | CHWs | Diagnosis |
32. | Chanda et al. [49] | CHWs | Treatment using anti-malarials |
33. | Ngasala et al. [50] | CHWs | Treatment using anti-malarials (ACT) |
34. | Phommanivong et al. [51] | Village health workers | Diagnosis using RDT Treatment of malaria |
35. | Yeboah-Antwi et al. [52] | CHWs | Diagnosis using RDT Treatment using ACT |
36. | Mukanga et al. [53] | CMDs | Diagnosis using RDT |
37. | Yasuoka et al. [17] | Village malaria workers | Diagnosis with RDTs Prescribing anti-malarials Active detection Explanations about compliance Follow-up of patients |
38. | Hawkes et al. [54] | CHWs | Diagnosis using RDT Treatment of febrile conditions/malaria |
39. | Eke et al. [55] | CHWs | Diagnosis using RDT |
40. | Tipke et al. | Volunteer community health workers | Treatment using modern medicine |
41. | Awor et al. [56] | Drug shop attendants | Malaria testing with RTD Malaria treatment with ACT |
42. | Cox et al. [57] | Village malaria workers | Surveillance of day 3-positive Plasmodium falciparum cases |
43. | Hamainza et al. [22] | CHWs | Diagnosis using RDT |
44. | Ndiaye et al. [58] | CHWs | Use of paediatric kit containing quinine, purified water, syringe |
45. | Das et al. [59] | Volunteers | Cases of fever treated during the 3-year period |
46. | Mbonye et al. [60] | Drug shop vendors, traditional birth attendants, community reproductive health worker, adolescent peer mobilizer | Delivery of SP doses to pregnant women |
47. | Vanek et al. [61] | CORPs | Number of malaria vector larval habitats |
48. | Cho-Min-Naing et al. [62] | Volunteer health workers | Sensitivities of malaria parasites tests |
49. | Kelly et al. [63] | CHWs | Treatment |
50. | Ruebush et al. [64] | Volunteer collaborators | Number of patients treated |
51. | Aung et al. [65] | CHWs | Diagnosis and treatment of paediatric malaria |
52. | Gidebo et al. [66] | CHWs | Diagnosis and treatment |
53. | Kalyango et al. [67] | CHWs | Treatment |
54. | Hamer et al. [68] | CHWs | Use of RDT |
55. | Mubi et al. [10] | CHWs | Provision of ACT |
56. | Harvey et al. [69] | CHWs | Use of RDT |
57. | Delacollette et al. [70] | CHWs | Treatment |
58. | Phommanivong et al. [51] | Village health volunteers | Use of RDT Provision of ACT |
59. | Eriksen et al. [71] | Women leaders | Role of women leaders in recognizing symptoms and providing first-line treatment for uncomplicated malaria |
60. | Kouyaté et al. [72] | Lay community women leaders | Malaria case management |
61. | Onwujekwe et al. [73] | CHWs | Malaria treatment |
62. | Mayxay et al. [74] | Village health volunteers | Use of RDT |
63. | Hii et al. [75] | Village health volunteers | Treatment |
64. | Spencer et al. [76] | Volunteer community health workers | Treatment with chloroquine |
65. | Ajayi et al. [77] | CHWs | Health promotion Treatment of malaria |
66. | Kweku et al. [78] | Community volunteers vs health workers in health facilities | Administration of amodiaquine plus SP |
Challenges of CHWs and related cadres in malaria interventions
SN | Citation | Cadre | Challenges |
---|---|---|---|
1. | Rodriguez et al. [20] | Health surveillance assistants | Short training not in-keeping with medical regulation standards for prescription Lack of resources to lengthen training Poor supervision and overburden with patients Most are found in remote and hard-to-reach areas where frequent supervision is not routine Job description keeps changing with more introduction of community interventions Financial instability and poor sustainability because of donor dependence and other unreliable sources |
2. | Chilundo et al. [21] | CHWs | Policy conflicts on prescription. Authority does not allow personnel with short-term training to prescribe Stock out of supplies especially anti-malarials Poor supervision especially in the hard to reach areas Funding instability. The programme is donor funded and subjected to delays in funding disbursement Lack of community involvement and ownership No evidence yet on impact and no evaluation strategy APEs are not paid |
3. | Yansaneh et al. [33] | CHVs | CHVs are not remunerated and have to do other income generating activities Not available when needed as they are not paid for their service |
4. | Nanyonjo et al. [30] | CHWs | Patients may not complete referrals |
5. | Heidkamp et al. [26] | CHWs | Stock-out of essential supplies Poor supervision from higher cadres |
6. | Druetz et al. [35] | CHWs | Community preference on qualified health workers CHWs not known to people Medicine stock-out Long distance to CHWs |
7. | Banek et al. [13] | CMDs | Patients overload Lack of supervision Limited malaria knowledge Tensions with community members Lack of remuneration from the government |
8. | Hamainza et al. [22] | CHWs | Lack of remuneration Negative attitudes to care given by CHWs Weak social responsibilities |
9. | Abbey et al. [24] | CHWs | High attrition rate of CHWs especially in hard-to-reach areas |
10. | Tine et al. [14] | CHWs | Medicine and RDT stock-out |
11. | Ndiaye et al. [39] | CHWs | Medicine and supply RDT stock-out (ACT, RDT, gloves, case files, patients forms) |
12. | Blanas et al. [28] | CHWs | ACT and other supplies stock-outs Expired medicines or unavailable in villages Scepticism from villages Transport problems, poor infrastructure and long distances for referrals |
13. | Counihan et al. [25] | CHWs | RDT and other medical supply stock-outs after initial supplies finished Lack of supervision Sustainability |
14. | Brenner et al. [23] | CHVs | Low turn-over of CHVs Low motivation Inconsistent supplies of medicine and supplies |
15. | Gidebo et al. [66] | CHWs | Shortage of chloroquine, Patient pressure to take coartem |
16. | Delacollette et al. [70] | CHWs | CHWs’ position remains ambiguous in the healthcare system. Non-comprehensive care may have negative effect on the sustainability of programme |
17. | Ajayi et al. [77] | CHWs |
Challenges in their promotion/training activities
The community members were not in support of the project. Some community members felt trainers were wasting their time Trainers could not conduct training all the time because of their domestic needs |