Professionalisation of Community Health Workers: Time for a Formal Contract.

Community health workers (CHWs) are the backbone of strong primary healthcare systems. If properly supported, they can add significant value to access to healthcare service delivery. Yet, despite their proven effectiveness globally, systemwide support for CHWs remains sub-optimal.

Building consensus on common features and interoperability use cases for community health information systems: a Delphi study.

Introduction: Information systems for community health have become increasingly sophisticated and evidence-based in the last decade and they are now the most widely used health information systems in many low-income and middle-income countries. This study aimed to establish consensus regarding key features and interoperability priorities for community health information systems (CHISs).

Methods: A Delphi study was conducted among a systematically selected panel of CHIS experts.

Barriers to access to ear and hearing care services in low- and middle- income countries: A scoping review.

People living in low- and middle- income countries (LMICs) meet significant challenges in accessing ear and hearing care (EHC) services. We conducted a scoping review to identify and summarise such barriers, to recognise gaps in the literature, and to identify potential solutions. Reviewers independently screened titles, abstracts and full-text articles and charted data.

The role of community healthcare workers in head and neck cancer: A systematic scoping review of the literature.

It is estimated that Head and Neck Cancer (HNC) will cause over 500,000 deaths worldwide by 2030. This is coupled with a shortage of trained healthcare professionals to manage HNC. An alternative cadre of workers - community healthcare workers (CHWs) - could be deployed to address this shortage.

Analysing 3429 digital supervisory interactions between Community Health Workers in Uganda and Kenya: the development, testing and validation of an open access predictive machine learning web app.

Background: Despite the growth in mobile technologies (mHealth) to support Community Health Worker (CHW) supervision, the nature of mHealth-facilitated supervision remains underexplored. One strategy to support supervision at scale could be artificial intelligence (AI) modalities, including machine learning. We developed an open access, machine learning web application (CHWsupervisor) to predictively code instant messages exchanged between CHWs based on supervisory interaction codes.

The use of low-cost ruggedized Android tablets to augment in-service training of community health workers in Mukono, Uganda: perspectives and lessons learned from the field.

Background: Despite potential for community health workers (CHWs) to effectively reduce morbidity and mortality in sub-Saharan Africa, they still face multiple barriers including access to on-going and refresher training. Digital technology offers a potential solution to improve the provision of ongoing training for CHWs.

Objectives: This report shares participant insights and experiences following the implementation of a mobile health (mHealth) assisted Integrated Community Case Management (iCCM) refresher training programme for CHWs in Mukono, Uganda.

Hip and groin pain prevalence and prediction in Elite Gaelic Games: 2703 male athletes across two seasons.

Objective: Hip and groin pain is highly prevalent in sub-elite Gaelic Athletic Association (GAA) athletes, but its prevalence at the elite level is unknown. The aims of this study were to report hip and groin pain prevalence in elite male athletes, to report changes in Copenhagen Hip and Groin Outcome Score (HAGOS) across two seasons and to assess if previous hip and groin pain or pre-season HAGOS could predict future hip and groin pain.

Methods: During the 2017 and 2018 pre-season male Gaelic Players Association (GPA) playing members were invited to complete two questionnaires.

Contested notions of challenges affecting Community Health Workers in low- and middle-income countries informed by the Silences Framework.

Despite increasing evidence of the challenges affecting Community Health Workers (CHWs) such as those related to training, supportive supervision and remuneration, there is a need to explore concerns and challenges from the perspective of CHWs themselves. This commentary highlights some of the contested and unexplored notions of challenges affecting CHWs in low- and middle-income countries (LMICs) informed by the Silences Framework. This framework defines experiences that are under-explored, misunderstood or difficult to share because of the often invisible power relations within communities, but also in setting the research agenda.

The Influence of Running on Lower Limb Cartilage: A Systematic Review and Meta-analysis.

Background: Running is a popular activity practiced worldwide. It is important to understand how running affects joint health to provide recommendations to sports medicine practitioners and runners.

Objective: Our aim was to summarize the influence of running on lower limb cartilage morphology and composition using quantitative magnetic resonance imaging (MRI).

Exploring supervision for volunteer community health workers in Mukono District, Uganda: An exploratory mixed-methods study.

Community Health Worker (CHW) supervision is an under-researched area. This mixed-methods study engaged key stakeholders involved in CHW supervision in Mukono District, Uganda including CHWs (=14), District Health Office officials (=5), NGO programme managers (=3) and facility-based health staff (=3). Our study aimed to explore how supervision is currently conceptualised and delivered in this setting, the desired qualities of a potential supervisor, as well as the challenges regarding supervision and potential solutions to address these.

Training, supervision and performance of Community Health Workers in the delivery of ear and hearing care to 321 community members in rural Uganda.

Objectives: Community Health Workers are one way to address the shortage of ear and hearing care specialists in low-resource settings. However, there are few reports evaluating training and service delivery by Community Health Workers.

Design, Setting And Participants: We trained 13 Community Health Workers in primary ear and hearing care in Mukono District, Uganda.

Attitudes of elite athletes and their support staff to the influenza vaccine.

Background: Influenza is an important public health issue, even amongst healthy adults. Uptake rates of the influenza vaccine amongst elite athletes vary and can depend on the attitudes of their coaches, fellow athletes and support staff. International studies have documented a fear amongst elite athletes to the potential side effects of the vaccine.

Association of artificial turf and concussion in competitive contact sports: a systematic review and meta-analysis.

Objective: To determine the incidence of head injuries and concussion in contact sports, comparing natural grass with artificial turf surfaces.

Design: Systematic review and meta-analysis via the RevMan V.5.

Community health workers in palliative care provision in low-income and middle-income countries: a systematic scoping review of the literature.

Background: Community health workers (CHWs) are currently deployed in improving access to palliative care in a limited number of low-income or middle-income countries (LMICs). This review therefore aimed to document evidence from LMICs regarding (1) where and how CHWs are currently deployed in palliative care delivery, (2) the methods used to train and support CHWs in this domain, (3) the evidence surrounding the costs attached with deploying CHWs in palliative care provision and (4) challenges and barriers to this approach.

Methods: We conducted a systematic scoping review of the literature, adhering to established guidelines.

Community health workers and early detection of breast cancer in low-income and middle-income countries: a systematic scoping review of the literature.

Background: Breast cancer is the leading cause of female mortality in low-income and middle-income countries (LMICs). Early detection of breast cancer, either through screening or early diagnosis initiatives, led by community health workers (CHWs) has been proposed as a potential way to address the unjustly high mortality rates. We therefore document: (1) where and how CHWs are currently deployed in this role; (2) how CHWs are trained, including the content, duration and outcomes of training; and (3) the evidence on costs associated with deploying CHWs in breast cancer early detection.

Exploring perceptions, barriers, and enablers for delivery of primary ear and hearing care by community health workers: a photovoice study in Mukono District, Uganda.

Background: Hearing loss is a prevalent but neglected disease, especially in low- or middle-income countries. The role of Community Health Workers (CHWs) to deliver primary ear and hearing care has been explored in several studies from a technical standpoint, but understanding perceptions, barriers, and enablers of such an approach from the perspective of CHWs themselves through a health equity lens has been less well documented.

Methods: This qualitative study used photovoice to explore the views and experiences of CHWs in the Seeta Nazigo Parish of Mukono District in the delivery of ear and hearing care in the community.

Participatory approaches, local stakeholders and cultural relevance facilitate an impactful community-based project in Uganda.

Sanitation is a major global challenge that is often addressed at national and international levels, while community opinions and beliefs are neglected. To promote water, sanitation and hygiene (WASH) we organized a cross-cultural knowledge exchange workshop to assess participatory methods for engaging local stakeholders. The workshop included 22 participants from all sectors of society.

'We are the people whose opinions don't matter'. A photovoice study exploring challenges faced by community health workers in Uganda.

Understanding the experiences of community health workers (CHWs) through the use of participatory visual methods (PVMs) has been relatively underexplored. One such PVM is photovoice, which involves the capture of photographic images related to issues of social importance. In this study, we explore challenges faced by eight CHWs in Mukono District, Uganda through the use of photovoice.

Perfusion of Intrapulmonary Arteriovenous Anastomoses Is Not Related to VO in Hypoxia and Is Unchanged by Oral Sildenafil.

Perfusion of intrapulmonary arteriovenous anastomoses (IPAVA) is increased during exercise and in hypoxia and is associated with variations in oxygen saturation (SO), resulting in blood bypassing the pulmonary microcirculation. Sildenafil is a pulmonary vasodilator that improves SO and endurance performance in hypoxia. The purpose of this study was to determine if 50 mg sildenafil would reduce IPAVA perfusion (Q) and if the decrement in maximal exercise capacity (VO) in hypoxia is related to Q.

Using mobile technologies to support the training of community health workers in low-income and middle-income countries: mapping the evidence.

Introduction: This paper maps the evidence published between 2000 and 2018 on the use of mobile technologies to train community health workers (CHWs) in low- and middle-income countries (LMICs) across nine areas of global healthcare, including the neglected areas of disability and mental health.

Methods: We used an evidence mapping methodology, based on systematic review guidelines, to systematically and transparently assess the available evidence-base. We searched eight scientific databases and 54 grey literature sources, developed explicit inclusion criteria, and coded all included studies at full text for key variables.