báo cáo sinh học:" 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"

Tuyển tập các báo cáo nghiên cứu về sinh học được đăng trên tạp chí sinh học quốc tế đề tài : 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 | Christopher et al. Human Resources for Health 2011 9 27 http content 9 1 27 HUMAN RESOURCES ulli FOR HEALTH REVIEW Open Access 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 Jason B Christopher1 Alex Le May1 Simon Lewin2 and David A Ross3 Abstract Background Over thirty years have passed since the Alma-Ata Declaration on primary health care in 1978. Many governments in the first decade following the declaration responded by developing national programmes of community health workers CHWs but evaluations of these often demonstrated poor outcomes. As many CHW programmes have responded to the HIV AIDS pandemic international interest in them has returned and their role in the response to other diseases should be examined carefully so that lessons can be applied to their new roles. Over half of the deaths in African children under five years of age are due to malaria diarrhoea and pneumonia - a situation which could be addressed through the use of cheap and effective interventions delivered by CHWs. However to date there is very little evidence from randomised controlled trials of the impacts of CHW programmes on child mortality in Africa. Evidence from non-randomised controlled studies has not previously been reviewed systematically. Methods We searched databases of published and unpublished studies for RCTs and non-randomised studies evaluating CHW programmes delivering curative treatments with or without preventive components for malaria diarrhoea or pneumonia in children in sub-Saharan Africa from 1987 to 2007. The impact of these programmes on morbidity or mortality in children under six years of age was reviewed. A descriptive analysis of interventional and contextual factors associated with these impacts was attempted. Results The review identified seven studies .