A review of generalist and specialist community health workers for delivering adolescent health services in sub-Saharan AfricaReportar como inadecuado




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Human Resources for Health

, 11:54

First Online: 26 October 2013Received: 16 January 2013Accepted: 15 October 2013

Abstract

BackgroundThe health of adolescents is increasingly seen as an important international priority because the world’s one point eight billion young people aged 10 to 24 years accounts for 15.5% of the global burden of disease and are disproportionately located in low- and middle-income countries LMICs. Furthermore, an estimated 70% of premature adult deaths are attributable to unhealthy behaviors often initiated in adolescence such as smoking, obesity, and physical inactivity. In order for health services to reach adolescents in LMICs, innovative service delivery models need to be explored and tested. This paper reviews the literature on generalist and specialist community health workers CHWs to assess their potential for strengthening the delivery of adolescent health services.

MethodsWe reviewed the literature on CHWs using Medline PubMed, EBSCO Global Health, and Global Health Archive. Search terms n = 19 were sourced from various review articles and combined with subject heading ‘sub-Saharan Africa’ to identify English language abstracts of original research articles on generalist and specialist CHWs.

ResultsA total of 106 articles, from 1985 to 2012, and representing 24 African countries, matched our search criteria. A single study in sub-Saharan Africa used CHWs to deliver adolescent health services with promising results. Though few comprehensive evaluations of large-scale CHW programs exist, we found mixed evidence to support the use of either generalist or specialist CHW models for delivering adolescent health services.

ConclusionsThis review found that innovative service delivery approaches, such as those potentially offered by CHWs, for adolescents in sub-Saharan Africa are lacking, CHW programs have proliferated despite the absence of high quality evaluations, rigorous studies to establish the comparative effectiveness of generalist versus specialist CHW programs are needed, and further investigation of the role of CHWs in providing adolescent health services in sub-Saharan Africa is warranted.

KeywordsCommunity health workers Youth friendly health services Adolescent health Sub-Saharan Africa AbbreviationsAFHSAdolescent Friendly Health Services

CHWCommunity health worker

HIVHuman immunodeficiency virus

LMICLow- and middle-income country

MDGMillennium Development Goals

NGONon-governmental organization

NTDNeglected tropical disease

PHCPrimary healthcare

RCTRandomized controlled trial

TBTuberculosis

UNUnited Nations

WHOWorld Health Organization

YFHSYouth Friendly Health Services.

Electronic supplementary materialThe online version of this article doi:10.1186-1478-4491-11-54 contains supplementary material, which is available to authorized users.

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Autor: Adam D Koon - Jane Goudge - Shane A Norris

Fuente: https://link.springer.com/







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